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2 Minute EBP Challenge

Monday, January 30, 2012
Scrub the Hub
The Centers for Disease Control (CDC) recommends that central venous catheter (CVC) hubs be scrubbed for how long?

Monday, January 23, 2012
Severe Sepsis and AF Risk
Up to 20% of patients with severe sepsis develop a new onset atrial fibrillation.  Which factor was not associated with increased risk?

Monday, January 16, 2012
Unreported Hospital Errors
In a recent study the Department of Health and Human Service reports that what percentage of hospital errors go unreported?

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  • Get tips, timesavers, and more from
    David W. Woodruff, MSN, RN-BC, CNS, CMSRN, CEN

    Home > 2 Minute EBP Challenge > Acetaminophen and vaccinations

    Acetaminophen and vaccinations

    Monday, November 02, 2009
     

    Stay up-to-date the easy way!

    How would you answer this question?

    Administering acetaminophen (Tylenol) at the time of pneumococcal or influenza vaccination may decrease fever and discomfort associated with vaccination, but is also associated with:

    a. Fever greater than 38 degrees C
    b. Swelling at the injection site
    c. Irritability in infants
    d. Decreased antibody responses

    The correct answer is "d," decreased antibody response.

    Acetaminophen (Tylenol) is often classified as a non-steroidal anti-inflammatory (NSAID) medication due to its action on cyclooxygenase 3 (COX3), which is very similar to COX1 that is blocked by other traditional NSAIDs.  The main effects of acetaminophen are the relief of fever and pain.  Acetaminophen is often prescribed for the relief of discomfort of vaccination injections.  In a recent study, the authors found a significant reduction in fever, pain, and irritability after vaccination in children who were premedicated with acetaminophen.

    Acetaminophen is not thought to reduce inflammation though, so theoretically it should not interfere with immunogenicity of vaccinations.  However, in their study, Prymula, et al. found a significant reduction in antibody responses to vaccination in the pretreated group.  Given the long history of administration of acetaminophen with vaccinations, it is likely that the magnitude of immune suppression caused by acetaminophen is primarily found in laboratory testing and not in clinical expression of disease.

    The authors recommend avoiding the prophylactic use of acetaminophen for vaccinations, unless the patient has moderate to severe complications from vaccinations.

    From: Prymula, R. et al. (2009).  Effect of prophylactic paractamol administration at the time of vaccination on febrile reactions and antibody response in children: Two open-label randomised controlled trials.  Lancet, 374:1339.

    Congratulations to Susan Weiss who won an autographed copy of my 101 Tips to Improve Your Nursing Care book for answering this week's question correctly.  Congratulations Susan!         

    Best wishes,
    David W. Woodruff, MSN, RN-BC, CNS, CEN
    President,     Ed4Nurses, Inc.

    (c) 2009 Ed4Nurses, Inc.  Feel free to print this e-mail and share it with your colleagues. Other forms of digital or print reproduction are prohibited without prior written consent from Ed4Nurses, Inc.
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