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Safety & Prevention

Many children and parents associate a trip to the pediatrician with shots. There are actually a couple of vaccines that we don’t give as an injection, specifically the oral rotavirus vaccine and nasal influenza vaccine. It would be great if we could give them all by mouth, but vaccines contain proteins and complex sugars that are digested quickly in the stomach, so the only way to get most of them into contact with the immune system is to inject them into the skin or muscle.

Combination Vaccines

The good news is that pediatricians have gotten better at minimizing or even eliminating the pain of vaccination. For one thing, we can often administer multiple vaccines in a single injection. The current record is 5.

Thanks to combination vaccines, the most separate injections many children receive at any given wellness examination is 3. We usually give these vaccines in the thighs during the first few years of life and in the shoulder muscles after that. When staff are available, they can use both legs at the same time to minimize the duration of discomfort. Because what pain there is tends to be experienced as a single event, it is discouraged for parents to spread vaccines out over multiple visits. There is no medical reason to do so, and it tends to prolong the discomfort for everyone.

Pain-Control Techniques

We now also have a variety of effective pain-control techniques.

  • Cooling spray can numb the skin just before shots are given so there is no poking sensation.
  • Another method uses a plastic plate covered with small points to block pain sensation.
  • Topical anesthetic creams can work in as little as 15 minutes to achieve the same effect.
  • For babies who are nursing, breastfeeding during a vaccination can provide significant pain relief as well.

Even without using any of these techniques, most babies calm down very quickly after their shots with being held. The calm in your voice and the firm reassurance of your embrace tell your baby that everything is fine. Remember, the shots may hurt for a moment, but the protection they’re giving your baby is good for a lifetime.

Adverse Reactions

By far the most common adverse reactions following vaccination are fever and fussiness, and sometimes there may be a little redness or swelling at the injection site. Many parents ask if they should give acetaminophen (eg, Tylenol, PediaCare Fever Reducer) or ibuprofen (eg, Motrin, Advil) prior to the vaccine visit. In the past we have encouraged using these medications to reduce any discomfort or potential fever from vaccines. Some newer studies have questioned whether giving acetaminophen might make the vaccines slightly less effective, so some pediatricians are no longer recommending it.

Any medication or vaccine has the potential to cause an allergic reaction, sometimes a severe one. Rates of severe allergic reactions with vaccines run in the 1 per million range, making them quite rare.

When to Call the Doctor

No symptoms after receiving vaccines should be dramatic. If your child has a temperature above 102°F or a fever that lasts more than a few days, or if she is unusually fussy, you should still consult her doctor and not just assume her symptoms are from vaccines.

If you notice your child getting hives, wheezing, or seeming unusually ill shortly after she gets vaccines, alert office staff if you’re still there or call emergency medical services (911) if you’re not.

 

Author
David L. Hill, MD, FAAP
Last Updated
11/1/2013
Source
Dad to Dad: Parenting Like a Pro (Copyright © American Academy of Pediatrics 2012)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.