Abstract
BackgroundProphylactic antipyretic administration decreases the post-vaccination adverse reactions. Recent study finds that they may also decrease the antibody responses to several vaccine antigens. This systematic review aimed to assess the evidence for a relationship between prophylactic antipyretic administration, post-vaccination adverse events, and antibody response in children.MethodsA systematic search of major databases including MEDLINE and EMBASE was carried out till March 2014. Randomized controlled trials (RCTs) comparing prophylactic antipyretic treatment versus placebo post-vaccination in children ≤6 years of age were included. Two reviewers independently applied eligibility criteria, assessed the studies for methodological quality, and extracted data [PROSPERO registration: CRD42014009717].ResultsOf 2579 citations retrieved, a total of 13 RCTs including 5077 children were included in the review. Prophylactic antipyretic administration significantly reduced the febrile reactions (≥38.0°C) after primary and booster vaccinations. Though there were statistically significant differences in the antibody responses between the two groups, the prophylactic PCM group had what would be considered protective levels of antibodies to all of the antigens given after the primary and booster vaccinations. No significant difference in the nasopharyngeal carriage rates (short-term and long-term) of H. influenzae or S. pneumoniae serotypes was found between the prophylactic and no prophylactic PCM group. There was a significant reduction in the local and systemic symptoms after primary, but not booster vaccinations.ConclusionsThough prophylactic antipyretic administration leads to relief of the local and systemic symptoms after primary vaccinations, there is a reduction in antibody responses to some vaccine antigens without any effect on the nasopharyngeal carriage rates of S. pneumoniae & H. influenza serotypes. Future trials and surveillance programs should also aim at assessing the effectiveness of programs where prophylactic administration of PCM is given. The timing of administration of antipyretics should be discussed with the parents after explaining the benefits & risks.
Highlights
Though routine vaccination is extremely beneficial for children, one of the reasons for non-compliance of children is the adverse effect of the previous vaccination [1,2]
This review summarized the findings pertaining only to DTP vaccination, and not to other childhood vaccinations
The current systematic review was planned to bridge this gap of information and provide any recommendation on the use of prophylactic antipyretics postvaccination in children based on the available evidence
Summary
Though routine vaccination is extremely beneficial for children, one of the reasons for non-compliance of children is the adverse effect of the previous vaccination [1,2]. Various side effects in the form of local (skin indurations, swelling, rash, pain, or erythema at injection site) and systemic reactions (fever, joint or muscle pain, vomiting, diarrhea, fainting, seizures, or other central nervous system effects) occur commonly after diphtheria, tetanus toxoids and pertussis (DTP) vaccination [3,4]. They usually occur within 24–48 hours following vaccination, are usually mild and self limited, but can result in discomfort in the child [3,4] It is a common practice for many health providers to suggest that an antipyretic be given preventively at the time of vaccine administration [5]. This systematic review aimed to assess the evidence for a relationship between prophylactic antipyretic administration, post-vaccination adverse events, and antibody response in children
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
