Prophylactic use of acetaminophen in children vaccinated with diphtheria-tetanus-pertussis

Area of Science:

• Pediatrics
• Immunology
• Pharmacology

Background:

• Booster diphtheria-tetanus-whole cell pertussis (DTP) vaccination is common in infants aged 15-20 months.
• Febrile responses and irritability are common post-vaccination reactions.
• The efficacy of prophylactic analgesics in mitigating these reactions is debated.

Purpose of the Study:

• To evaluate the effect of prophylactic acetaminophen administration on febrile responses following a DTP booster vaccination in infants.
• To compare the incidence of local and systemic reactions between prophylactic and reactive acetaminophen use.

Main Methods:

• A randomized non-blind trial involving 270 healthy infants aged 15-20 months.
• Infants were assigned to receive acetaminophen concurrently with DTP, 2 hours post-vaccination, or as needed for fever/irritability (control).
• Local and systemic reactions, including fever, were monitored for 7 days post-vaccination.

Main Results:

• No significant differences in local reactions (swelling, pain, erythema) were observed among the groups.
• Incidences of systemic reactions, including fever (axillary temperature ≥38°C), irritability, anorexia, and vomiting, did not differ significantly.
• Fever occurred in 45.1%, 46.7%, and 51.9% of infants in the concurrent, 2-hour, and control groups, respectively (P>0.05).

Conclusions:

• Prophylactic acetaminophen administration with or 2 hours after DTP booster vaccination does not reduce febrile responses in infants.
• Routine prophylactic use of analgesics for DTP booster vaccination is not supported by these findings.
• Preventing unnecessary analgesic use in infants post-vaccination is advised.