Should Acetaminophen be Given Routinely After Vaccination in Infants?

Acetaminophen post vaccination in infants cannot be recommended due to its very low incidence of febrile seizures post vaccination and its interference with immunity.

Routine use of paracetamol after vaccination in infants cannot be recommended, suggests studies.

Acetaminophen (or paracetamol) is the most common medication used for fever in children. It is an effective and safe drug when used in its normal dosage.

Febrile Fits - Causes Symptoms Diagnosis Treatment Prevention
High fever in kids can cause convulsions and are called febrile fits that do not include the seizures that occur as a result of brain infection.

Some children experience high temperature or fever following vaccination. This fever very rarely reaches proportions where it could cause complications like seizures. However, it could cause discomfort and disruption of sleep in the child as well as her parents. Parents may have to miss work to take care of the child. The fever may also introduce doubts in the minds of the parents regarding the safety of immunizations.

Should acetaminophen be administered to infants routinely after immunization to prevent fever? Researchers conducted a study in Washington to find an answer to this question. 352 infants less than 10 months of age were included in the study. They were administered either acetaminophen or an inert substance called placebo that was similar in appearance to acetaminophen. The parents were not aware which preparation the child was administered.

The researchers found that infants that received acetaminophen were less likely to have fever compared to those that did not receive this medicine, though this difference was not significant. They were also less likely to be fussy post vaccination. Thus acetaminophen given to prevent fever appears to be beneficial.

High fever was reported in only 3 infants who did not receive acetaminophen and febrile seizures were not reported in any infant in the study. Thus, none of the infants that did not receive acetaminophen have serious fever-related complications.

Another similar study, however, indicated that routine use of acetaminophen with vaccines could decrease the immune response to vaccination and thereby reduce its benefits.

Clinical approach to a child with fever
A good clinical history and a thorough physical examination should form the basis of making a provisional diagnosis. Laboratory tests should be supportive.

The researchers thus concluded that although use of acetaminophen to prevent fever in infants post vaccination helps to control their temperature and reduce fussiness, it could interfere with the immune response elicited by the vaccines. Also, fever post vaccination very rarely reaches dangerous proportions. Thus, its routine use in this situation cannot be recommended currently.

Reference:

Fever - First Aid and Emergency Treatment Guide
Fever also called as pyrexia is higher-than-normal body temperature. A quick and simple First Aid guide on how to administer treatment for Fever.

1. Jackson LA, Peterson D, Dunn J, Hambidge SJ, Dunstan M, Starkovich P, Yu O, Benoit J, Dominguez-Islas CP, Carste B, Benson P, Nelson JC. A Randomized Placebo-Controlled Trial of Acetaminophen for Prevention of Post-Vaccination Fever in Infants. PLoS One. 2011; 6(6): e20102.

Source-Medindia