title: Comparison of distress and pain in infants randomized to groups receiving standard versus multiple immunizations.
abstract: This randomized controlled trial compared distress and pain in healthy 4-month-old infants receiving three different immunizations either sequentially (control, n=50) or simultaneously, two at the same time, followed by the third (experimental, n=51). Although both groups demonstrated a significant increase in cortisol from baseline levels, the lack of significant difference on salivary cortisol between groups post-immunization suggests the study was underpowered. On NIPS scores, the experimental group demonstrated significantly less pain (Mann-Whitney U=1648.0, p=0.003). Simultaneous injections appeared to be effective in reducing pain behavior responses in infants receiving their 4-month immunizations. Longitudinal studies could determine whether reduced exposure to pain in infancy, through simultaneous immunization injections, could contribute to a reduction in sensitivity to pain and physiologic stress responses.
authors.affiliation: Vancouver Coastal Health, Pacific Spirit Health Centre, 2110 West 43rd Avenue, Vancouver, BC V6M 2E1, Canada.
authors.forename: Denise
authors.initials: D
authors.lastname: Hanson
authors.forename: Wendy
authors.initials: W
authors.lastname: Hall
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Mills
authors.forename: Scholastica
authors.initials: S
authors.lastname: Au
authors.forename: Radhika
authors.initials: R
authors.lastname: Bhagat
authors.forename: Michelle
authors.initials: M
authors.lastname: Hernandez
authors.forename: Natalie
authors.initials: N
authors.lastname: Slomba
authors.forename: Reem
authors.initials: R
authors.lastname: Ali
mesh_terms: D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007114:Immunization / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D007223:Infant; D018730:Infant Behavior; D008297:Male; D010146:Pain / Q000209:etiology* / Q000378:metabolism; D010147:Pain Measurement; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000209:etiology* / Q000378:metabolism; D014611:Vaccination / Q000009:adverse effects / Q000379:methods* / Q000523:psychology*
chemical_list: D006854:Hydrocortisone