title: Effect of change in sequence of administration of DTwP and Hepatitis B vaccines on perception of pain in infants: A randomized control trial.
abstract: OBJECTIVE
  This study was designed with objective to study pain response of infants to change in sequence of administration of Hepatitis B and DTwP vaccines.
  
  
  METHODS
  This was a randomized parallel control trial. The study was carried out in the immunization clinic of the Department of Pediatrics, LLRM Medical College, Meerut. One hundred and thirty healthy term infants up to 4 months of age were injected either DTwP vaccine first or Hepatitis B vaccine first, followed one minute later by the other vaccine.
  
  
  RESULTS
  Baseline characteristics did not differ between the groups. The mean (SD) of AUC of MFCS and NIPS was significantly more in DF group as compared to HF group (for MFCS 25.5 ± 5.4 versus 22.5 ± 5.5, p<0.01; for NIPS 31.77 ± 5.5 versus 27.64 ± 6.9, p < 0.01). Similarly mean (SD) of AUC of Heart rate and saturation of oxygen showed significant variation in DF group as compared to HF group (for heart rate 591.6 ± 55 versus 559.6 ± 49, p< 0.01; for SpO2 326.4 ± 12 versus 335 ± 8, p < 0.01).
  
  
  CONCLUSIONS
  These results showed that infant experienced lesser pain when Hepatitis B was administered first than when DTwP vaccine was given first.
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut UP 250004, India.
authors.forename: Mithilesh
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut UP 250004, India. Electronic address: au.llrm@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Upadhyay
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut UP 250004, India.
authors.forename: Jeevika
authors.initials: J
authors.lastname: Singh
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut UP 250004, India.
authors.forename: Manika
authors.initials: M
authors.lastname: Chhabra
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut UP 250004, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut UP 250004, India.
authors.forename: Navratan Kumar
authors.initials: NK
authors.lastname: Gupta
authors.affiliation: Department of Pediatrics, LLRM Medical College, Meerut UP 250004, India.
authors.forename: Aditya
authors.initials: A
authors.lastname: Bhat
authors.affiliation: Department of Biostatistics, All India Institute of Medical Science New Delhi, India.
authors.forename: C P
authors.initials: CP
authors.lastname: Yadav
mesh_terms: D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D008297:Male; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D014611:Vaccination / Q000379:methods*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D017325:Hepatitis B Vaccines
keywords: DTwP vaccine; Hepatitis B vaccine; Infants; Modified Facial Coding System (MFCS); Neonatal Infant Pain Scale (NIPS)