Pairing influenza and pneumococcal vaccination shots for children raises risk of fever

However, the benefits associated with inoculation still outweigh the fever risk, CDC says

NEW YORK — Giving young children the influenza and pneumococcal vaccines together appears to increase their risk of fever, according to a study led by researchers from Columbia University Medical Center and the Centers for Disease Control and Prevention released Monday afternoon. However, the fever was brief, and medical care was sought for few children, supporting the routine immunization schedule for these vaccines, including the recommendation to administer them simultaneously. 

The study, which looked at children 6–23 months old, was published online on Jan. 6, 2014, in Journal of the American Medical Association Pediatrics.

“While our data suggest that giving children the influenza and pneumococcal vaccines together at the same visit increases the risk of fever, compared with getting only one of the vaccines at the visit, these findings should be viewed in context of the benefit of vaccines to prevent serious illness in young children, as well as the recognized need to increase vaccination rates overall,” stated study first author Melissa Stockwell, Florence Irving Assistant Professor of Pediatrics and Population and Family Health at Columbia College of Physicians and Surgeons, with a joint appointment at Columbia’s Mailman School of Public Health. “Parents should be made aware that their child might develop a fever following simultaneous influenza and pneumococcal vaccinations — but that the benefits of these vaccines outweigh the risk of fever and, in most cases, the fever will be brief,” Stockwell said. “For the small group of children who must avoid fever, these findings provide important information for clinicians and parents.”

The study followed 530 children recruited during the 2011–2012 influenza season from three community-based clinics affiliated with New York-Presbyterian and Columbia University Medical Center, who were receiving their usual vaccinations.

After controlling for age and other factors, among children who received simultaneous influenza and pneumococcal vaccines, about a third (37.6%) had a fever of 100.4 F or higher on the day of or day after vaccination, compared with children who received only the pneumococcal (9.5%) or only the influenza (7.5%) vaccine. In other words, children receiving the influenza and pneumococcal vaccine together were about three times as likely to have a fever on the day of or day after vaccination, compared with children who received either vaccine alone. 

There were no differences among the groups in rates of fever in the two to seven days after vaccination.

“We are committed to making sure that the safety of vaccines is continuously monitored and to better understanding any potential risks associated with vaccination,” stated Claudia Vellozzi, deputy director of the Immunization Safety Office at the Centers for Disease Control and Prevention, and the study’s senior author. “This study also demonstrates how novel approaches, like text messaging to assess fever following vaccination, can be used to enhance vaccine-safety monitoring.”

 

 

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