Do prophylactic antipyretics reduce vaccination-associated symptoms in children?

Abstract

Q: Do prophylactic antipyretics reduce vaccination-associated symptoms in children? Yes for acetaminophen, not so much for ibuprofen. Prophylactic acetaminophen reduces the odds of febrile reactions in the first 48 hours after vaccination by 40% to 65% and pain of all grades by 36% to 43%. In contrast, prophylactic ibuprofen reduces pain of all grades by 34% only after primary vaccination and doesn't alter pain after boosters. Nor does it alter early febrile reactions (strength of recommendation [SOR]: B, meta-analysis of randomized clinical trials [RCTs] with moderate-to-high risk of bias). Prophylactic administration of acetaminophen or ibuprofen is associated with a reduction in antibody response to the primary vaccine series and to influenza vaccine, but antibody responses still achieve seroprotective levels (SOR: C, bench research).