Acetaminophen and Ibuprofen for Prevention of Adverse Reactions Associated with Childhood Immunization
Bibliographic record
Abstract
OBJECTIVE: To evaluate the literature examining prophylactic use of acetaminophen and ibuprofen for prevention of adverse reactions associated with childhood immunization. DATA SOURCES: Articles were identified via MEDLINE/PubMed/EMBASE (1966-March 2007) using the following key terms: vaccination, immunization, diphtheria-tetanus toxoids-whole pertussis (DTwP), diphtheria tetanus-toxoid, whole pertussis, diphtheria-tetanus toxoids-acellular pertussis (DTaP), acellular pertussis, Haemophilus influenzae type B, inactivated poliovirus, pneumococcal 7-valent conjugate, measles, mumps, rubella, meningococcal C-conjugate, varicella zoster, hepatitis B, influenza, pneumococcal polysaccharide, adverse reactions, analgesics, antipyretics, acetaminophen, ibuprofen, infant, and child. STUDY SELECTION AND DATA EXTRACTION: No limitations were placed on article selection. DATA SYNTHESIS: Five articles examining the effects of prophylactic acetaminophen or ibuprofen for adverse effects associated with either DTaP or DTwP vaccine were retrieved. In one randomized controlled trial of children aged 4-6 years given DTaP, no effect of prophylactic acetaminophen 15 mg/kg/dose, up to 450 mg, or ibuprofen 10 mg/kg/dose, up to 300 mg, was found on the incidence of fever, redness, pain, swelling, or itching. In 3 randomized studies of DTwP, either acetaminophen 10-15 mg/kg/dose or ibuprofen 20 mg/kg/24 hours, given in 3 equal doses before or at the time of immunization and every 4-8 hours thereafter for 12 or more hours, reduced fever, pain, fussiness, and local redness in infants 2-7 months of age compared with placebo. Results were not duplicated in older infants/children. No studies investigated use of prophylactic acetaminophen or ibuprofen for any other vaccine. CONCLUSIONS: Use of prophylactic acetaminophen and ibuprofen may reduce the incidence of adverse reactions in young infants receiving DTwP vaccine; however, DTwP has been replaced with DTaP, and no benefits have been demonstrated for this vaccine when evaluated in children aged 4-6 years, or with any other vaccine currently in use. Thus, neither drug can be recommended prophylactically to prevent vaccine-associated adverse reactions. Individuals at high risk for seizures may, however, warrant special consideration.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.007 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".