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

Abstract：

OBJECTIVE:Prophylactic antipyretic use during pediatric vaccination is common. This study assessed whether paracetamol or ibuprofen prophylaxis interfere with immune responses to the 13-valent pneumococcal conjugate vaccine (PCV13) given concomitantly with the combined DTaP/HBV/IPV/Hib vaccine. METHODS:Subjects received prophylactic paracetamol or ibuprofen at 0, 6-8, and 12-16 h after vaccination, or 6-8 and 12-16 h after vaccination at 2, 3, 4, and 12months of age. At 5 and 13months, immune responses were evaluated versus responses in controls who received no prophylaxis. RESULTS:After the infant series, paracetamol recipients had lower levels of circulating serotype-specific pneumococcal anticapsular immunoglobulin G than controls, reaching significance (P<0.0125) for 5 serotypes (serotypes 3, 4, 5, 6B, and 23F) when paracetamol was started at vaccination. Opsonophagocytic activity assay (OPA) results were similar between groups. Ibuprofen did not affect pneumococcal responses, but significantly (P<0.0125) reduced antibody responses to pertussis filamentous hemagglutinin and tetanus antigens after the infant series when started at vaccination. No differences were observed for any group after the toddler dose. CONCLUSIONS:Prophylactic antipyretics affect immune responses to vaccines; these effects vary depending on the vaccine, antipyretic agent, and time of administration. In infants, paracetamol may interfere with immune responses to pneumococcal antigens, and ibuprofen may reduce responses to pertussis and tetanus antigens. The use of antipyretics for fever prophylaxis during infant vaccination merits careful consideration. ClinicalTrials.gov identifier: NCT01392378https://clinicaltrials.gov/ct2/show/NCT01392378?term=NCT01392378&rank=1.

journal_name

Vaccine

journal_title

Vaccine

authors

Wysocki J,Center KJ,Brzostek J,Majda-Stanislawska E,Szymanski H,Szenborn L,Czajka H,Hasiec B,Dziduch J,Jackowska T,Witor A,Kopińska E,Konior R,Giardina PC,Sundaraiyer V,Patterson S,Gruber WC,Scott DA,Gurtman A

doi

10.1016/j.vaccine.2017.02.035

subject

Has Abstract

pub_date

2017-04-04 00:00:00

pages

1926-1935

issue

15

eissn

0264-410X

issn

1873-2518

pii

S0264-410X(17)30229-3

journal_volume

35

pub_type

杂志文章,随机对照试验

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