Prophylactic paracetamol at the time of infant vaccination reduces the risk of fever but also reduces antibody response

Homme, Jason H; Fischer, Philip R

doi:10.1136/ebm1049

Prophylactic paracetamol at the time of infant vaccination reduces the risk of fever but also reduces antibody response

Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA

Correspondence to Philip R Fischer
Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; fischer.phil{at}mayo.edu

Commentary on:

Prymula R,
Siegrist CA,
Chlibek R,
et al

. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet 2009;374:1339–50.

Although immunisation is one of the great accomplishments of the field of public health1 and routine vaccination is extremely beneficial for children, families and care providers are well aware that bothersome side effects of immunisation are common. For many providers, it is common practice to suggest that an antipyretic be given preventively at the time of vaccine administration2 – even though the value of this practice has not been fully proven.3 Prymula and colleagues compared postvaccine fever and postvaccine changes in vaccine-specific antibody titres in children who either did or did not receive scheduled paracetamol with immunisations.

At 10 centres in the Czech Republic, 459 healthy infants undergoing initial (9–16 weeks of age) and booster (12–15 months of age) vaccinations (oral rotavirus vaccine, and intramuscular 10-valent pneumococcal …

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