Fever after Immunization: Current Concepts and Improved Future Scientific Understanding

Kohl, Katrin; Marcy, S. Michael; Blum, Michael D.; Jones, M. C.; Dagan, Ron; Hansen, John; Nalin, David R.; Rothstein, E. P.

doi:10.1086/422454

Cited by 67 publications

(57 citation statements)

References 52 publications

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“…[8][9][10] Fever retards the growth and reproduction of bacteria and viruses, enhances neutrophil production and T-lymphocyte proliferation, and aids in the body's acute-phase reaction. [11][12][13][14] The degree of fever does not always correlate with the severity of illness.…”

Section: Physiology Of Fevermentioning

confidence: 99%

“…7,9,[21][22][23] Fever is a common and normal physiologic response that results in an increase in the hypothalamic "set point" in response to endogenous and exogenous pyrogens. 9,23 In contrast, hyperthermia is a rare and pathophysiologic response with failure of normal homeostasis (no change in the hypothalamic set point) that results in heat production that exceeds the capability to dissipate heat. 9,23 Characteristics of hyperthermia include hot, dry skin and central nervous system dysfunction that results in delirium, convulsions, or coma.…”

Section: Physiology Of Fevermentioning

confidence: 99%

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Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

366

313

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Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers and a frequent cause of parental concern. Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a “normal” temperature. Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child's overall comfort rather than focus on the normalization of body temperature. When counseling the parents or caregivers of a febrile child, the general well-being of the child, the importance of monitoring activity, observing for signs of serious illness, encouraging appropriate fluid intake, and the safe storage of antipyretics should be emphasized. Current evidence suggests that there is no substantial difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever. There is evidence that combining these 2 products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices.

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Section: Physiology Of Fevermentioning

confidence: 99%

Section: Physiology Of Fevermentioning

confidence: 99%

Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

366

313

View full text Add to dashboard Cite

show abstract

“…7 Parents should realise that fever is not an illness, but is, in fact, a physiological mechanism that has beneficial effects in fighting infection. 8,9 A study by Crocetti et al indicated that parents still have a limited understanding of fever. Also, they found little change in the knowledge of American mothers, beliefs and practices over a 20-year interval.…”

Section: Introductionmentioning

confidence: 99%

“…Parents should know that fever is not an illness, but is, in fact, a physiological mechanism that has beneficial effects in fighting infection. 8,9 The practice of alternating two types of antipyretics has become widespread at home and paediatric wards, but is this method supported by evidence and does it results in complications? 36 There is still a significant contrast between scientific evidence on the one hand and current concepts and practices on the other.…”

mentioning

confidence: 99%

Kuwaiti parent's knowledge of their childern's fever and their patterns of use of over the counter antipyretics

Badawy¹,

Alhajraf²,

Alsamdan³

2017

AMJ

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“…5 Before 2009, infants commonly received prophylactic acetaminophen treatment to prevent immunization discomfort and fever, although there is a low level of evidence for effectiveness. [6][7][8] In 2009, Prymula et al 9 published data from a randomized controlled trial (RCT) that showed reduced immunogenicity when infants (3-5 months of age) received 3 doses of acetaminophen in the first 24 hours after primary vaccines. This led some authors to reconsider the practice, 10 whereas others advocated maintaining the current practice.…”

mentioning

confidence: 99%

Infant Sleep After Immunization: Randomized Controlled Trial of Prophylactic Acetaminophen

2011

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WHAT'S KNOWN ON THIS SUBJECT:For adults, sleep deprivation before or after immunization is associated with decreased antigen-specific antibody formation, but little is known about infant sleep before and after immunization or the effects of prophylactic acetaminophen treatment on infant sleep. WHAT THIS STUDY ADDS:Infants demonstrated increased sleep duration in the 24 hours after immunization, particularly if they were immunized after 1:30 PM and had elevated temperatures. Acetaminophen use was associated with smaller increases in sleep duration but not when other factors were controlled. abstract OBJECTIVE: To determine the effects of acetaminophen and axillary temperature responses on infant sleep duration after immunization. METHODS:We conducted a prospective, randomized controlled trial to compare the sleep of 70 infants monitored by using ankle actigraphy for 24 hours before and after their first immunization series at ϳ2 months of age. Mothers of infants in the control group received standard care instructions from their infants' health care provider, and mothers of infants in the intervention group were provided with predosed acetaminophen and instructed to administer a dose 30 minutes before the scheduled immunization and every 4 hours thereafter, for a total of 5 doses. Infant age and birth weight and immunization factors, such as acetaminophen use and timing of administration, were evaluated for changes in infant sleep times after immunization. RESULTS:Sleep duration in the first 24 hours after immunization was increased, particularly for infants who received their immunizations after 1:30 PM and for those who experienced elevated temperatures in response to the vaccines. Infants who received acetaminophen at or after immunization had smaller increases in sleep duration than did infants who did not. However, acetaminophen use was not a significant predictor of sleep duration when other factors were controlled. CONCLUSIONS:If further research confirms the relationship between time of day of vaccine administration, increased sleep duration after immunization, and antibody responses, then our findings suggest that afternoon immunizations should be recommended to facilitate increased sleep in the 24 hours after immunization, regardless of acetaminophen administration.

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Fever after Immunization: Current Concepts and Improved Future Scientific Understanding

Cited by 67 publications

References 52 publications

Fever and Antipyretic Use in Children

Fever and Antipyretic Use in Children

Kuwaiti parent's knowledge of their childern's fever and their patterns of use of over the counter antipyretics

Infant Sleep After Immunization: Randomized Controlled Trial of Prophylactic Acetaminophen

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