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.
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.
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.
References :
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
Careers
I agree with the conclusion of the article but not with the reason given for it. The article fails to mention that there are significant safety issues associated with this drug, due to its toxicity. It is e.g. responsible for by far the greatest number of therapeutic poisonings in children. Lowering a fever is in any case dangerous as fever plays an important role in dealing with infections. "...evidence suggests that aspirin and paracetamol [the generic name for acetaminophen] increase mortality in severe infection, and that they may prolong the infection and reduce the antibody response in mild disease." Aust Prescr 1995; 18: 233-234, Frank Shann, Intensive Care Unit, Royal Children's Hospital, Melbourne Giving this drug following the administration of vaccines is doubly dangerous as vaccines and acetaminophen may both impair liver function.