Greater Glasgow and Clyde Medicines

Paracetamol to prevent and treat fever after MenB vaccination in babies aged 2-4 months

Advice for healthcare professionals

Key messages:

• NHS Public Health Scotland advise giving paracetamol suspension 120mg/5ml (sugar free) at the time of MenB vaccination, or as soon as possible afterwards, in order to reduce the risk of the baby developing a fever.

• Parents and carers are given an information leaflet prior to the MenB vaccination which provides advice on giving paracetamol. Paracetamol infant suspension 120mg/5ml (sugar free) can be obtained from community pharmacies.

• For babies born before 32 weeks gestation and currently weighing less than 4kg, paracetamol for post vaccination fever must be prescribed by a GP according to the baby’s weight at the time of vaccination. EMIS synonyms have been updated to guide prescribing. Refer to the table at the end of the blog for weight-based dosing advice.

• The dosing instructions for giving paracetamol after MenB vaccination are based on expert recommendation for this specific situation and may differ to those in the product literature for paracetamol suspension (for the relief of pain and other causes of fever).

• The main differences in dosing instructions relate to how many doses of paracetamol to give the baby before seeking medical advice:

  • The baby should be given 3 regular doses of paracetamol following MenB vaccination, even if they do not have a fever (see dosing table)
  • In the 48 hours after vaccination, if the baby still has a fever but is otherwise well, further doses of paracetamol can be given according to the product literature (or prescription for babies born before 32 weeks gestation and currently weighing less than 4kg)
  • If the baby still has a fever more than 48 hours after vaccination then medical advice should be sought

Background:

Fever can be expected after any vaccination but is more common when the MenB vaccine is given with the other routine vaccinations at 2 and 4 months old. The fever tends to peak around 6 hours after vaccination and is nearly always completely gone within 48 hours.

Three regular doses of paracetamol are recommended following MenB vaccination (see dosing table). This is in contrast to advice in the manufacturer’s patient information leaflet for paracetamol suspension which recommends that children aged 2-4 months should only be given 2 doses of paracetamol before speaking to a doctor or pharmacist. Parents and carers are given an information leaflet prior to the MenB vaccination which emphasises that the advice to give more than 2 doses of paracetamol to babies aged 2-4 months only applies after the baby has had the MenB vaccination.

Weight-based dosing advice for paracetamol suspension 120mg/5ml (sugar free) for use after MenB vaccination in babies aged 2 – 4 months:

(if viewing table on mobile device, switch to landscape)

Published: 20/09/2022. Medicines Update blogs are correct at the time of publishing