We do not recommend routinely giving paracetamol before immunisation with childhood vaccines just in case a child gets a fever or has injection site pain. This is because a high fever or injection site pain are not very common responses.
The recommendation around the use of paracetamol for Bexsero, the meningococcal group B vaccine offered to all infants on the National Immunisation Schedule, is different. Fever can occur in some infants as part of their normal response to Bexsero, usually peaking around 6 hours after immunisation and settling over 24–48 hours.
Similarly, redness, swelling and/or mild–moderate pain around the injection site are also common expected immune responses to Bexsero, peaking on the day of vaccination and settling from around 24 hours after immunisation.
For these reasons, routine use of paracetamol with every dose of Bexsero in children aged under 2 years, whether given alone or with other vaccines, is recommended to reduce the risk of high fever and injection site pain. Some infants will still develop a fever and/or injection site pain even though they have received paracetamol doses.
Bexsero is routinely offered on the NIS at the 3–month, 5–month and 12 month immunisation events. Paracetamol should be used for all infants receiving Bexsero at these events and will not reduce the effectiveness of other vaccines received.
Paracetamol should also be used for infants receiving Bexsero on the alternate schedule, at 2–months, 4–months and 12 months.
Three doses of paracetamol are recommended with 4 to 6 hours between each dose, whether the child has a fever or not.
Liquid paracetamol is available with a prescription from your doctor or as an ‘over the counter’ purchase at a pharmacy.
• Liquid paracetamol is available in two strengths; please ensure you have the correct infant strength of 120mg/5ml.
• Know the right dose to give, follow the advice of your doctor or the dosage instructions on the bottle.
• Measure the paracetamol dose using a measuring spoon or syringe.
• No more than four doses of paracetamol can be given in a 24-hour period.
• Too much paracetamol can be dangerous.
If you are concerned about your child after their immunisation, contact your family doctor or nurse. You can also call Healthline on 0800 611 116 day or night.
If your child gets hot or has a fever
• Give lots of breastfeeds or fluids
• Undress them to a single layer, for example a singlet and pants
• Make sure the room is not too hot or too cold
• Give lots of cuddles
If your child has injection site discomfort or pain
• Do not rub the injection site
• Hold a cool damp cloth or an ice pack well wrapped in a dry cloth on the injection site
• Give lots of cuddles