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A randomized study of fever prophylaxis and the immunogenicity of routine pediatric vaccinations

Jacek Wysocki1, Kimberly J Center2, Jerzy Brzostek3

  • 1Department of Preventive Medicine, Poznań University of Medical Sciences, ul. Smoluchowskiego 11, 60-179 Poznań, Poland.

Vaccine
|March 7, 2017
PubMed

Insights

Routine use of prophylactic antipyretics like paracetamol or ibuprofen during infant vaccination may impact immune responses. Paracetamol reduced pneumococcal antibody levels, while ibuprofen affected pertussis and tetanus responses.

Area of Science:

  • Pediatric immunology
  • Vaccinology
  • Pharmacology

Background:

  • Prophylactic antipyretic use is common in infants during vaccination.
  • Concerns exist regarding potential interference with vaccine-induced immune responses.

Purpose of the Study:

  • To evaluate the impact of prophylactic paracetamol and ibuprofen on immune responses to the 13-valent pneumococcal conjugate vaccine (PCV13) and a combined DTaP/HBV/IPV/Hib vaccine in infants.
  • To assess if antipyretic administration timing influences these immune responses.

Main Methods:

  • Infants received prophylactic paracetamol or ibuprofen at specific intervals post-vaccination.
  • Immune responses to PCV13 and DTaP/HBV/IPV/Hib vaccines were measured at 5 and 13 months of age.
  • Responses were compared between antipyretic groups and a no-prophylaxis control group.

Main Results:

  • Paracetamol prophylaxis, especially when initiated at vaccination, led to significantly lower pneumococcal anticapsular immunoglobulin G levels for five serotypes.
  • Ibuprofen did not affect pneumococcal responses but reduced antibody responses to pertussis and tetanus antigens.
  • No significant differences in immune responses were observed after the toddler vaccine dose for any group.

Conclusions:

  • Prophylactic antipyretics can alter vaccine immune responses, with effects varying by agent, vaccine, and administration timing.
  • Paracetamol may dampen infant immune responses to pneumococcal antigens, while ibuprofen may affect responses to pertussis and tetanus antigens.
  • The use of antipyretics for fever prophylaxis during infant vaccination warrants careful consideration due to potential immunomodulatory effects.
Abstract

Keywords:
AntipyreticIbuprofenImmune responseInfantParacetamolPneumococcal conjugate vaccine

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