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The Effect of Prophylactic Paracetamol Upon Post Vaccination Fever and Related Adverse Events in Preterm Infants Receiving the Bexsero Vaccine

Presented at the Neonatal Society 2017 Summer Meeting.

Dubus M, Vasu V

East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, Kent, TN24 0LZ

Background: Following the introduction of the Bexero© vaccine against Meningitis B into the routine vaccination schedule in the UK, Public Health England advised administration of 3 doses of Paracetamol alongside the vaccine (1). This advice was based upon the observation of increased post Bexero© febrile reactions in term infants. However, evidence to support this strategy in preterm infants was lacking. We have previously demonstrated a significant increase in a number of pre-defined adverse events in preterm infants post Bexero© vaccination who did not receive prophylactic paracetamol (2). Here, we present data on a cohort of preterm infants who have received the Bexero© vaccine and prophylactic paracetamol to assess the impact of paracetamol administration upon post vaccination fever and adverse events.

Methods: We conducted a retrospective note review of all preterm infants (<37 weeks GA) who had received vaccinations at the William Harvey Hospital, Ashford, Kent. Data were collected in three epochs: epoch 1 (Pre Bexero©: 1 September 2014 – September 2015), epoch 2 (post Bexero©/unit policy of not administering prophylactic paracetamol: September 2015 – March 2016), epoch 3 (post Bexero©/unit policy of administering prophylactic paracetamol: June 2016 – March 2017). Data regarding post vaccine fever and pre-defined adverse events in the 48 hours post vaccination were collected and are illustrated in Table 1 below.

Results: See table.

The Effect of Prophylactic Paracetamol Upon Post Vaccination Fever and Related Adverse Events in Preterm Infants Receiving the Bexsero Vaccine

Conclusion: Our data suggest that administration of 3 prophylactic doses of paracetamol to preterm infants post Bexsero© vaccination reduces the rate of post vaccination fever, the need for partial septic screens, lumbar punctures and antibiotics. However, whether this strategy affects vaccine immunogenicity in the preterm population requires further research.

Corresponding author: vimal.vasu@nhs.net

1. Public Health England (2015) Clinical Guidance on Immunisation of Infants against Meningococcal B Disease [Online], London. Available at https://www.gov.uk/government/….pdf(Accessed 16 May 2016)
2. Dubus M, Vasu V. Is the use of prophylactic paracetamol to prevent febrile reactions justified in hospitalised ex preterm infants receiving the new Meningitis B (Bexero) vaccination? Neonatal Society Summer Meeting, Cambridge 2016

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