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The effect of prophylactic acetaminophen administration on reactions to DTP vaccination
K Lewis1, J D Cherry, M H Sachs
1Department of Pediatrics, UCLA School of Medicine 90024.
Insights
Prophylactic acetaminophen significantly reduced fever, pain, and fussiness in children after diphtheria, tetanus toxoids, and pertussis vaccination. This intervention improved comfort and reduced the need for additional pain relief.
Area of Science:
- Pediatrics
- Immunology
- Pharmacology
Background:
- Diphtheria and tetanus toxoids and pertussis (DTaP) vaccination is crucial for child health.
- Post-vaccination reactions like fever and pain can cause distress and reduce vaccine adherence.
Purpose of the Study:
- To evaluate the efficacy of prophylactic acetaminophen in mitigating adverse reactions following DTaP vaccination in children.
- To assess the impact of pre-emptive acetaminophen on fever, pain, and fussiness post-immunization.
Main Methods:
- A double-blind, randomized controlled trial involving 282 children.
- Participants received either acetaminophen or placebo before and at intervals after DTaP vaccination.
- Monitoring of fever, local, and systemic reactions, with provisions for rescue acetaminophen.
Main Results:
- Acetaminophen recipients exhibited significantly lower overall reaction scores compared to placebo.
- A significant reduction in the incidence and severity of fever, fussiness, and injection site pain was observed.
- Fewer children in the acetaminophen group required rescue medication.
Conclusions:
- Prophylactic acetaminophen effectively moderates common reactions associated with DTaP immunization.
- Pre-emptive acetaminophen administration enhances child comfort and potentially improves tolerance to vaccination schedules.
Abstract:
To determine the effect of prophylactic acetaminophen on reactions after diphtheria and tetanus toxoids and pertussis vaccination, 282 children received either acetaminophen or placebo in a double-blind, randomized fashion before and 3, 7, 12, and 18 hours after vaccination. Fever and local and systemic reactions were monitored. Switching to known acetaminophen was permitted if the patient's temperature was 38.9 degrees C or higher or for moderate pain. Overall, the reaction score of acetaminophen recipients was significantly less than that of placebo recipients. The rates of occurrence of fever and fussiness and the degree of pain at the injection site were significantly reduced by acetaminophen administration. Children who received acetaminophen were less likely to be switched to "open" acetaminophen than placebo recipients. It is concluded that prophylactic acetaminophen as given in this study had a moderating effect on fever, pain, and fussiness after diphtheria and tetanus toxoids and pertussis immunization.