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Alexa Sheehan is in the pharmacy with her baby daughter Grace.

“Oh, she’s gorgeous,” exclaims pharmacy technician Vicky. 

“Thank you” replies Alexa. “The time is going really fast though, she’s six weeks old already.”

“Ah, so she must be due her first jabs soon – assuming you are doing them?” asks Vicky.

“Oh yes, definitely,” Alexa replies. “To be honest, I’m relieved they are still managing to offer them, what with Covid and all. But that’s why I’m here, actually, do I need to get something to give Grace beforehand to stave off any side effects?”

Answer

The most common side effects following infant vaccinations are soreness around the injection site(s) for a few days, and sometimes a fever. However, the ‘Green Book’, which provides information for public health professionals involved in immunisations, advises against giving simple analgesics prophylactically with the aim of trying to prevent these effects because there is evidence that this practice can lower the antibody response. 

However, the meningitis B (MenB) vaccine – one of the three jabs given at eight weeks of age as part of the routine NHS immunisation schedule (see page 6) – is strongly associated with the development of a fever, so it is recommended that babies are given a dose of liquid paracetamol as soon as possible after vaccination, followed by two more doses at four to six hourly intervals. Ibuprofen is seemingly less effective than paracetamol at controlling post-vaccination fever and so is not recommended, while aspirin is not advised at all in those aged under 16 years unless prescribed by a doctor.

Other measures that can help include making sure the baby has plenty to drink in order to avoid dehydration, and ensuring they are not wearing too many layers of clothes or blankets. Vicky may want to offer Alexa some practical and emotional support as well, as having your baby vaccinated can feel quite daunting, particularly the first time. She can reassure her she will be able to cuddle Grace on her lap during the appointment, and remind her to take Grace’s personal child health record – in England, this is often called the ‘Red Book’ – on the day, as well as dressing her in clothing that is easy to undo and refasten so the injection site in the thigh can be easily accessed.

If Grace is unwell before her jabs, Alexa should contact the provider for advice on whether to proceed with the appointment or to postpone. And if she seems to have severe adverse effects afterwards, the same applies regarding contacting the provider, and she may want to complete a report via the Yellow Card scheme.

The bigger picture

The UK’s immunisation programme is considered world-leading, and there is little doubt that vaccination is an incredibly impactful public health intervention, protecting the individual and also the wider community; some three million deaths are prevented each year as a result. Vaccinations are offered throughout people’s lives and delivered by a range of providers. However, they are not mandatory, and consent must be sought before each vaccine is given. It is also OK for people to change their minds – most vaccines can be caught up on if they have been missed.