Giving paracetamol to children before or after a vaccine?

Giving paracetamol to children, to avoid the occurrence of fever reaction following a vaccination could reduce the formation of protective antibodies triggered by vaccination, suggests a study published in the British medical journal The Lancet.

Fever is part of normal reactions after vaccination and appears frequently after infection, say the authors. But give some fairly systematic preventive paracetamol in children vaccinated before.

The study was conducted by Professor Roman Prymula (Hradec Kralove, Czech Republic) on 459 children, a group receive paracetamol pre-emptively, the other one not. Not surprisingly, a smaller proportion of children who received the drug had a fever post-vaccination among those who did not have (42% against 66% in primary vaccination and 36% against 58% for a second injection).

However, measuring the immune response to the vaccine, as measured by the concentration of protective antibodies directed against one or more infectious agents (or toxins) covered by the vaccine, was the opposite.

Thus, in children treated preventively by this antipyretic, antibody levels were significantly lower. They are directed against strains of pneumococci (causes pneumonia and meningitis), diphtheria, tetanus or bacterial meningitis caused by the bacterium Haemophilus influenzae type b (Hib). A phenomenon observed especially after the first injection.

This observation needs further verification, but the preventive use of paracetamol should be recommended routinely now, without having carefully weighed the advantages and disadvantages, say the authors.

It is steel needed to check if the prophylactic use of paracetamol increases or not the proportion of nonresponders to the vaccine and whether it is more likely to largely reduce the protection level of populations, especially against the transmission of pneumococci.

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