177: Comparison of Oral Sucrose Solution and Oral Rotavirus Vaccine for Reducing Pain During Infant Vaccine Injections
Bibliographic record
Abstract
Although sweet-tasting substances such as sucrose solution have been demonstrated to reduce pain in infants undergoing routine vaccine injections, they are rarely utilized in clinical practice. Oral rotavirus vaccine is administered concomitantly with injectable vaccines in two- and four-month-old infants and contains sweet-tasting substances, including sucrose. At present, there is no guidance regarding the order of administration of rotavirus relative to injectable vaccines resulting in some clinicians administering it before and others after. If analgesic, rotavirus administration could be standardized to precede injectable vaccines so as to confer the added benefit of reducing pain from subsequent vaccine injections and sucrose would not be needed. The objective was to compare the analgesic effectiveness of sucrose and oral rotavirus when administered prior to injectable vaccines. Two- and four-month-old infants receiving routine injectable vaccines (Diphtheria, Tetanus and acellular Pertussis/Inactivated Polio/Haemophilus influenza type b and Pneumococcal conjugate) were randomized to receive oral sucrose before the injectable vaccines and rotavirus (Rotarix™) afterwards or rotavirus before and sucrose afterwards. The order of injections was standardized (pneumococcal conjugate vaccine last). Parents and clinicians were blinded to order of administration and assessed pain in real time after each injection using an 11-point numerical rating scale (where 0=no pain and 10=worst possible pain). The pain score for each injection and average pain score for both injections was used in the analysis. Altogether, 120 infants participated: 60 were randomized to sucrose first. The mean age, sex and weight of infants did not differ statistically between groups (P>0.05 for all analyses). Parent pain ratings in the sucrose group vs. the rotavirus group during the 1st and 2nd vaccine injections were: 3.9 (2.6) vs. 3.0 (2.3), P=0.066; and 7.7 (2.0) vs. 6.8 (2.4), P=0.046, respectively. Clinician pain ratings were: 3.0 (2.4) vs. 2.3 (2.2), P=0.110, and 6.3 (2.3) vs. 6.1 (2.4), P=0.643, respectively. The average pain score for both injections was lower in the rotavirus group for parent ratings but not for clinician ratings: 5.8 (2.1) vs. 4.9 (2.1); P=0.032, and 4.6 (2.2) vs. 4.2 (2.1), P=0.269, respectively. The results demonstrated that rotavirus possesses analgesic properties. Based on the findings, rotavirus administration is recommended to precede injectable vaccines in order to obtain the added benefit of analgesia. In this context, sucrose solution is not needed. Additional research may examine if there is an additional benefit of sucrose when added to rotavirus.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".