Calpol given before immunisations

[sarah00001]

Hi, My baby has just had her second set of immunisations at 12 weeks. Both at the 8 week and 12 week jabs, the nurse gave her Calpol right before the injections. I've just read however that this can make the immunsations less effective. Is this something I should be concerned about?

Thanks, Sarah

[Idefix]

Did you baby have men b? If so the paracetamol is given to prevent a fever that is very likely (62% of baby's given men b in trials developed a high temp). If given men b you should have been given a leaflet recommending regular paracetamol for the first 24 hours and a further 24 hours if needed.

[sarah00001]

Yes she had Men B, however I read today that Calpol is meant to be given after the injections and not before as giving it before can make the jabs less effective. I didn't question it when the nurse gave the calpol prior to the jabs as I trusted that she knew that she was doing. I'm just really worried now...

[DriverSurpriseMe]

NHS guidelines recommend giving Calpol immediately after the Men B vaccination, so giving it right before makes no difference from a time POV. It's just a few minutes difference.

I can't see how Calpol could reduce the efficacy of the vaccination. If it did, the NHS wouldn't recommend it. And if it's given just before, well, it's barely even hit the stomach so the body wouldn't have started processing it.

[Idefix]

Giving it before should be fine, I give it immediately after to separate it from the Rotarix.
The main advice at the moment is not to give before attending clinic as it will not be possible to assess that the child is fever free before having jabs.

The new advice is confusing lots of people. For the previous two yrs I have been advising to not have calpol for mild fever as research and guidelines suggested that it was suppressing the bodies uptake. Now we are saying to give the calpol but it is only necessary for the times when men b is given. This is because it is known to cause high fever.

Hth

[sarah00001]

Thank you for your help. Idefix, you're right the advice is confusing. Hopefully my baby will be fine, like 'Driver' says, the NHS wouldn't recommend it if it made it less effective.

[dratsea]

Driver I also struggle to see why paracetamol should make a difference to the immune response, but multiple doses do seem to have an effect. The exact wording of the advice from NHS is:

There was no reduction in immunity following just a single dose of paracetamol or the use of paracetamol to treat a developed fever. It was only the regular use of preventative paracetamol use that was associated with decreased immune response.

Routine, regular doses of paracetamol at time of vaccinations is not advised in NZ.

The advice is based on a 2009 article in The Lancet (funded by the vaccine manufacturer). You will need to pay to read the full article on line but you may find The Lancet available in your local hospital library. You can read the abstract for free. The opinion of the authors of an editorial in BMJ was split, further studies were advised but I do not think they have been done. To be honest what really matters is if the vaccination is effective, not what changes can be detected in a blood sample.

If it is of any help to OP our children got every vaccine going (and a few beside) and no paracetamol.

[dratsea]

sarah Just to add, our children had vaccinations long before Men B was available, the youngest is in GCSE year! And The Meningitis Foundation do recommend paracetamol but only for the 8 and 12 week jabs and not the booster at 12 months.

A total of three 2.5ml doses should be given. The first dose should be administered at the time of vaccination or as soon as possible afterwards. The second and third doses should be administered at 6-8 hourly intervals after the previous dose.

[DriverSurpriseMe]

Dratsea - the advice to give paracetamol at the immunisation appointment is unique to the Meningitis B vaccine, which is a very new addition to the NHS vaccination schedule (so new that my DS didn't get it at 8 weeks as scheduled because it hadn't been rolled out yet; he got it at 16 weeks).

Here are the official information leaflets, including the protocol for HCPs and parent information leaflets - the second one was given to me by the practice nurse.

www.gov.uk/government/publications/menb-vaccine-and-paracetamol

[DriverSurpriseMe]

Incidentally that was the first time he'd ever had Calpol - I didn't give him any after his 8 and 12 weeks vaccinations because he didn't seem to need it. I was all set to watch and wait after the 16 week vaccinations as well, but the practice nurse whipped out a sachet and said "I need to give him this now". I was a bit alarmed but he was fine. A bit hotter and grumpier than usual, but nothing worrying.

[dratsea]

Driver Thank you for that very good link. The sections with information for parents, sadly, do not seem to address the question the OP very wisely asked. Sarah please award yourself a . Although the acting on the video on the health professionals page will never get nominated for an OSCAR it is accessible to, and should be required viewing for, any MN who understandably has concerns about an apparent change of policy re: paracetamol and vaccinations. I am not an immunologist, but as a simple surgeon I guess a mild fever may be part of the process of setting the immune response, which is why the advice used to be against giving prophylactic paracetamol for the 8 and 12 week vaccinations. But if a new vaccine (such as Men B) has been found to normally drive up the temperature, and possibly to levels that distress infants (and parents), it makes sense to give the paracetamol to prevent the additional problems of the Men B but in the expectation of a slight pyrexia that will still set the immune system appropriately to the other components of the 8 and 12 week jabs. By the age of a year an infant can better thermoregulate so best not to give paracetamol.

[DdramaLlama]

It seems that it may make more sense to be giving the MenB vaccine separately so that paracetamol can be given if needed without it affecting the response to the other vaccines.

[Mimington]

My DD has her second jabs next week, are they as bad as the first ones? She fully screamed for over an hour after the first one (after a nap on the way home) and wouldn't feed. Would like to know if I need to be prepared for this again! :/

[AwolFlower]

@Mimington
The second ones are ok, because they are not the meningitis ones, which tend to cause a fever.
My ds didn't need calpol after those ones but did after the 1st and 3rd ones.