Paracetamol weakens children's response to vacciantion

Paracetamol is sometimes given to infants to reduce their risk of developing fever or a fit caused by fever. In the UK, paracetamol (acetaminophen) is sold over the counter, also present in brands such as Panadol and Calpol. In the US it is more commonly available as Tylenol.

A study published in The Lancet, funded by GlaxoSmithKline Biologicals of Belgium, investigated the effect of giving paracetamol to infants during and immediate after vaccination.

459 healthy infants aged between 9 and 16 weeks were recruited from 10 centres in the Czech Republic and randomised to receive either paracetamol administered every 6 to 8 hrs during the 24 hrs following vaccination or to receive no paracetamol. The parents knew the treatment assigned to their babies.

Researchers found that in both groups, fever above 39.5 degrees C was uncommon, however lower proportion of babies in the paracetamol group had temperature above 38 degrees C. After the primary vaccine doses, more paracetamol doses had to be given to the babies in the control group than the treatment group. They also found that the antibody concentrations following the primary immunisations were significantly lower in the paracetamol group than in the control group and the response varied depending on the vaccination type given.

They concluded that "Although febrile reactions significantly decreased, prophylactic administration of antipyretic drugs at the time of vaccination should not be routinely recommended since antibody responses to several vaccine antigens were reduced."

Critics say this is an important study because there was very few published studies on this issue but further study is needed to demonstrate whether the immunity offered by flu vaccination might be reduced by paracetamol. It may be wise not to give paracetamol routinely to babies as a preventive measure.

Source: "Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials" The Lancet 2009; 374: 1339-1350 (press release or f/t via Athens)

Elective caesareans linked to respiratory morbidity

More and more women request a Caesarean section without good medical reasons, a lot of them are completely unaware of the negative impact on their baby.

A large-scale study carried out by Dannish experts involving 34,458 deliveries between 37 and 41 weeks found babies born through elective Caesarean are up to four times more likely to suffer breathing problems compared with those born naturally or by emergency Caesarean. The earlier the Caesarean is carried out, the higher the risk. The researchers advised women not to carry out elective Caesareans before 39 weeks. The report is published by the BMJ.

Source : "Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study" BMJ Online (published 11 December 2007)