Infant Sleep After Immunization: Randomized Controlled Trial of Prophylactic Acetaminophen

Abstract

WHAT'S KNOWN ON THIS SUBJECT:For adults, sleep deprivation before or after immunization is associated with decreased antigen-specific antibody formation, but little is known about infant sleep before and after immunization or the effects of prophylactic acetaminophen treatment on infant sleep. WHAT THIS STUDY ADDS:Infants demonstrated increased sleep duration in the 24 hours after immunization, particularly if they were immunized after 1:30 PM and had elevated temperatures. Acetaminophen use was associated with smaller increases in sleep duration but not when other factors were controlled. abstract OBJECTIVE: To determine the effects of acetaminophen and axillary temperature responses on infant sleep duration after immunization. METHODS:We conducted a prospective, randomized controlled trial to compare the sleep of 70 infants monitored by using ankle actigraphy for 24 hours before and after their first immunization series at ϳ2 months of age. Mothers of infants in the control group received standard care instructions from their infants' health care provider, and mothers of infants in the intervention group were provided with predosed acetaminophen and instructed to administer a dose 30 minutes before the scheduled immunization and every 4 hours thereafter, for a total of 5 doses. Infant age and birth weight and immunization factors, such as acetaminophen use and timing of administration, were evaluated for changes in infant sleep times after immunization. RESULTS:Sleep duration in the first 24 hours after immunization was increased, particularly for infants who received their immunizations after 1:30 PM and for those who experienced elevated temperatures in response to the vaccines. Infants who received acetaminophen at or after immunization had smaller increases in sleep duration than did infants who did not. However, acetaminophen use was not a significant predictor of sleep duration when other factors were controlled. CONCLUSIONS:If further research confirms the relationship between time of day of vaccine administration, increased sleep duration after immunization, and antibody responses, then our findings suggest that afternoon immunizations should be recommended to facilitate increased sleep in the 24 hours after immunization, regardless of acetaminophen administration.

The Effect of Prophylactic Antipyretic Administration on Post-Vaccination Adverse Reactions and Antibody Response in Children: A Systematic Review

“…Besides these, the findings of another RCT [24] reporting about the infant sleep after immunization and relation of acetaminophen (paracetamol) use need mention here. This RCT found that paracetamol use post-immunization (not prophylactic) was associated with increase in the infant sleep duration.…”

Experiences, perceptions and preferences of mothers towards childhood immunization reminder/recall in Ibadan, Nigeria: a cross-sectional study

“…Previous studies in New York City and Kansas in USA have revealed a wide support and acceptability for text messages / short message service (SMS) as a mode of immunization reminder/recall [ 20 – 23 ]. Also, person to person telephone reminders has also been found to be preferred by parents in studies in Nigeria and USA [ 18 , 24 ]. It is possible that mothers who preferred cellphone call reminders in this study may have done so because they are likely to have the opportunity to express themselves if they plan to attend their children schedule immunization clinic or request to change appointment date if they cannot attend for any reason [ 25 ].…”

“…Meanwhile, maternal age was not a significant predictor of preference for cell phone calls or SMS in the current study. However, findings from previous study in USA showed that parents aged 30 years and above preferred e-mail for reminder [ 24 ].…”

Adverse events following immunization of COVID-19 vaccine among children aged 6–11 years

“…Supangat et al ( 29 ) reported that sleepiness was the second most common systemic effect among Indonesian medical clerkship students after receiving the CoronaVac vaccine. Another study by Franck et al ( 30 ) found that sleep duration in the first 24 h after immunization was increased. Hendarto et al ( 31 ) and Rachman et al ( 32 ) found that feeling hungry is one of the AEFI symptoms reported by Indonesian CoronaVac recipients.…”