Korea Human Resource Development Institute for Health and Welfare, Cheongju, Republic of Korea.
Yonsei University College of Medicine, Seoul, Republic of Korea.
JMIR Mhealth Uhealth. 2019 Apr 22;7(4):e12223. doi: 10.2196/12223.
Postvaccination fever is a mild adverse event that naturally improves without complications, but is highly prevalent and can be accompanied by febrile convulsions in some cases. These adverse effects may cause parents to delay or avoid vaccinating their children.
This study aimed to identify postvaccination fever patterns and the ability of antipyretics to affect changes in these patterns from data collected from a mobile app named Fever Coach.
Data provided by parents of feverish children derived from a mobile app, Fever Coach, were used to identify postvaccination fever patterns according to vaccinations and the use of antipyretic drugs. We selected single vaccination records that contained five or more body temperature readings performed within 48 hours of vaccination, and we analyzed postvaccination fever onset, offset, duration, and maximum body temperature. Through observing the postvaccination fever response to vaccination, we identified the effects of antipyretic drugs on postvaccination fever onset, offset, and duration times; the extent of fever; and the rate of decline. We also performed logistic regression analysis to determine demographic variables (age, weight, and sex) involved in relatively high fevers (body temperature ≥39°C).
The total number of Fever Coach users was 25,037, with 3834 users having entered single vaccination records, including 4448 vaccinations and 55,783 body temperature records. Most records were obtained from children receiving the following vaccinations: pneumococcus (n=2069); Japanese encephalitis (n=911); influenza (n=669); diphtheria, tetanus, and pertussis (n=403); and hepatitis A (n=252). According to the 4448 vaccination records, 3427 (77.05%) children had taken antipyretic drugs, and 3238 (89.15%) children took antibiotics at body temperatures above 38°C. The number of children taking antipyretics at a body temperature of 38°C was more than four times that of those taking antipyretics at 37.9°C (307 vs 67 cases). The number of instances in which this temperature threshold was reached was more than four times greater than the number when the temperature was 37.9°C. A comparative analysis of antipyretic and nonantipyretic cases showed there was no difference in onset time; however, offset and duration times were significantly shorter in nonantipyretic cases than in antipyretic cases (P<.001). In nonantipyretic cases, offset times and duration times were 9.9 and 10.1 hours shorter, respectively, than in antipyretic cases. Body temperatures also decreased faster in nonantipyretic cases. Influenza vaccine-associated fevers lasted relatively longer, whereas pneumococcus vaccine-associated fevers were relatively short-lived.
These findings suggest that postvaccination fever has its own fever pattern, which is dependent on vaccine type and the presence of antipyretic drugs, and that postvaccination temperature monitoring may ease fever phobia and reduce the unnecessary use of antipyretics in medical care.
接种疫苗后发热是一种轻微的不良反应，通常无需治疗即可自行缓解，但它的发病率较高，且某些情况下可能伴有热性惊厥。这些不良反应可能导致家长延迟或避免为孩子接种疫苗。
本研究旨在通过 Fever Coach 移动应用收集的数据，识别接种疫苗后发热模式，并评估退热剂对这些模式变化的影响。
利用 Fever Coach 移动应用中发热儿童家长提供的数据，根据疫苗接种情况和退热药物使用情况，识别接种疫苗后发热模式。我们选择了记录有 5 次或 5 次以上体温测量值的单剂疫苗接种记录，这些测量值在接种后 48 小时内完成。我们分析了接种后发热的起始时间、结束时间、持续时间和最高体温。通过观察接种后发热对疫苗接种的反应，我们确定了退热药物对发热起始时间、结束时间和持续时间的影响，以及发热程度和下降速度。我们还进行了逻辑回归分析，以确定与高热（体温≥39°C）相关的人口统计学变量（年龄、体重和性别）。
Fever Coach 应用程序的总用户数为 25037 人，其中 3834 人输入了单剂疫苗接种记录，包括 4448 次疫苗接种和 55783 次体温记录。大多数记录来自接种以下疫苗的儿童：肺炎球菌（n=2069）；乙型脑炎（n=911）；流感（n=669）；白喉、破伤风和百日咳（n=403）；和甲型肝炎（n=252）。根据 4448 次疫苗接种记录，3427 名（77.05%）儿童使用了退热药物，3238 名（89.15%）儿童在体温高于 38°C 时使用了抗生素。体温 38°C 时使用退热药物的儿童数量是体温 37.9°C 时的四倍多（307 比 67 例）。达到该体温阈值的次数是体温 37.9°C 时的四倍多。退热和未退热病例的比较分析显示，发热起始时间无差异，但未退热病例的发热结束时间和持续时间明显短于退热病例（P<.001）。在未退热病例中，发热结束时间和持续时间分别比退热病例短 9.9 和 10.1 小时。未退热病例的体温下降速度也更快。流感疫苗相关发热持续时间相对较长，而肺炎球菌疫苗相关发热持续时间相对较短。
这些发现表明，接种疫苗后发热有其自身的发热模式，这种模式取决于疫苗类型和退热药物的使用，接种后体温监测可能有助于减轻家长对发热的恐惧，并减少医疗保健中不必要的退热药物使用。
