title: Prophylactic antipyretics for prevention of febrile seizures following vaccination.
abstract: QuestionParents of a 12-month-old boy are bringing their son in to my family practice clinic for his well-baby visit. As the infant is due for his 12-month vaccine series, the parents are concerned after hearing about the association between certain vaccinations and an increased risk of febrile seizures, and are wondering if they should administer prophylactic antipyretics to decrease the risk of febrile seizure. What vaccinations are associated with increased risk of febrile seizure, and is there evidence supporting prophylactic administration of antipyretics to prevent febrile seizures?AnswerVaccinations associated with increased risk of febrile seizure include the following: the measles-mumps-rubella vaccine; the measles-mumps-rubella-varicella vaccine; the combined diphtheria, tetanus, acellular pertussis, polio, andHaemophilus influenzaetype b vaccine; the whole-cell pertussis vaccine; the 7-valent pneumococcal conjugate vaccine; and concomitant administration of the trivalent inactivated influenza vaccine with either the 7-valent pneumococcal conjugate vaccine or the diphtheria, tetanus, and acellular pertussis vaccine. Despite being a higher-risk group, children receiving these vaccinations should not receive prophylactic antipyretics, as no statistically significant reduction in the rate of febrile seizures has been documented, and prophylactic antipyretic use potentially decreases the immune response to certain vaccines.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Monfries
authors.forename: Ran D
authors.initials: RD
authors.lastname: Goldman
mesh_terms: D058633:Antipyretics / Q000627:therapeutic use*; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000009:adverse effects; D018073:Haemophilus Vaccines / Q000009:adverse effects; D000069443:Heptavalent Pneumococcal Conjugate Vaccine / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007252:Influenza Vaccines / Q000009:adverse effects; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000009:adverse effects; D010567:Pertussis Vaccine / Q000009:adverse effects; D023321:Poliovirus Vaccines / Q000009:adverse effects; D003294:Seizures, Febrile / Q000139:chemically induced* / Q000517:prevention & control*; D014611:Vaccination / Q000009:adverse effects; D014612:Vaccines / Q000009:adverse effects*
chemical_list: D058633:Antipyretics; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D018073:Haemophilus Vaccines; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D007252:Influenza Vaccines; D022542:Measles-Mumps-Rubella Vaccine; D010567:Pertussis Vaccine; D023321:Poliovirus Vaccines; D014612:Vaccines