“…Third, the use of antipyretics was at the discretion of the participants, with 6–7 % reporting their use before receiving the monovalent and bivalent boosters. Although concerns exist that pre-vaccination antipyretic use might influence the emergence of adverse reactions, our previous research found no significant differences in the frequency of adverse reactions, including fever, based on antipyretic use before the monovalent booster [19] . Similar results were observed with the bivalent booster in this study as shown in Table s2 , suggesting that the presence of participants who used antipyretics before vaccination likely had a minimal impact on the primary outcome.…”