title: Effect of antipyretic analgesics on immune responses to vaccination.
abstract: While antipyretic analgesics are widely used to ameliorate vaccine adverse reactions, their use has been associated with blunted vaccine immune responses. Our objective was to review literature evaluating the effect of antipyretic analgesics on vaccine immune responses and to highlight potential underlying mechanisms. Observational studies reporting on antipyretic use around the time of immunization concluded that their use did not affect antibody responses. Only few randomized clinical trials demonstrated blunted antibody response of unknown clinical significance. This effect has only been noted following primary vaccination with novel antigens and disappears following booster immunization. The mechanism by which antipyretic analgesics reduce antibody response remains unclear and not fully explained by COX enzyme inhibition. Recent work has focused on the involvement of nuclear and subcellular signaling pathways. More detailed immunological investigations and a systems biology approach are needed to precisely define the impact and mechanism of antipyretic effects on vaccine immune responses.
authors.affiliation: a Department of Pediatrics , Division of Pediatric Infectious Diseases, Duke Clinical Vaccine Unit, Duke University School of Medicine , Durham , NC , USA.
authors.forename: Ezzeldin
authors.initials: E
authors.lastname: Saleh
authors.affiliation: b Duke Human Vaccine Institute, Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University School of Medicine , Durham , NC , USA.
authors.forename: M Anthony
authors.initials: MA
authors.lastname: Moody
authors.affiliation: c Duke Clinical Vaccine Unit, Department of Pediatrics, Divisions of Primary Care and Pediatric Infectious Diseases, Duke University School of Medicine , Durham , NC , USA.
authors.forename: Emmanuel B
authors.initials: EB
authors.lastname: Walter
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D058633:Antipyretics / Q000008:administration & dosage*; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D016896:Treatment Outcome; D014612:Vaccines / Q000008:administration & dosage* / Q000276:immunology*
chemical_list: D000700:Analgesics; D058633:Antipyretics; D007155:Immunologic Factors; D014612:Vaccines
keywords: NSAIDs; antibody responses; antipyretic analgesics; immune responses; prophylaxis; vaccination