{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:49:55Z","timestamp":1791881395663,"version":"4.3.4"},"reference-count":12,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Post\u2010vaccination fever is a common adaptive immune response. Antipyretics are frequently used in paediatric practice to manage symptoms; however, concerns have emerged regarding potential interference with vaccine\u2010induced immunogenicity, particularly when administered prophylactically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review of paediatric studies assessing prophylactic and therapeutic use of paracetamol and ibuprofen after routine vaccinations was conducted. Evidence was derived from randomized trials, systematic reviews, and real\u2010world health\u2010economic analyses, focusing on fever, reactogenicity, antibody titers, and clinical safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prophylactic paracetamol consistently reduced fever but was associated with attenuated antibody titers during the primary vaccine series, notably with pneumococcal conjugate vaccines. Ibuprofen showed no measurable immunogenic suppression but is not recommended as a routine preventive strategy. Therapeutic antipyretic use, administered only after symptom onset, demonstrated no negative effect on immune responses. Ibuprofen was more effective than paracetamol for fever reduction in symptomatic children but is unsuitable in infants &lt;\u20096\u2009months. Prophylactic paracetamol is selectively justified only in high\u2010reactogenicity contexts (e.g., 4CMenB) or in children at risk of febrile seizures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Routine pre\u2010dosing of antipyretics should be avoided. A symptom\u2010based approach optimizes immune priming, ensures clinical safety, and supports adherence to vaccination schedules.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70571","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:21:30Z","timestamp":1777954890000},"page":"2491-2497","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Paracetamol versus Ibuprofen Before and After Paediatric Vaccination: A Clinical Evidence Review"],"prefix":"10.1111","volume":"115","author":[{"given":"Gianvincenzo","family":"Zuccotti","sequence":"first","affiliation":[{"name":"Department of Biomedical and Clinical Science University of Milan  Milan Italy"},{"name":"Pediatric Department Buzzi Children's Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Science University of Milan  Milan Italy"},{"name":"Pediatric Department Buzzi Children's Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2137-5974","authenticated-orcid":false,"given":"Valeria","family":"Calcaterra","sequence":"additional","affiliation":[{"name":"Pediatric Department Buzzi Children's Hospital  Milan Italy"},{"name":"Pediatric and Adolescent Unit, Department of Internal Medicine University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002\u20109343(01)00834\u20108"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.33393\/grhta.2025.3579"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(09)61208\u20103"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2016.1223001"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.02.035"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106629"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2016.1183077"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.10.020"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2017.03.009"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.85"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.22398"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2021.1928617"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70571","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apa.70571","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70571","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:16:25Z","timestamp":1791879385000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.70571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":12,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/apa.70571"],"URL":"https:\/\/doi.org\/10.1111\/apa.70571","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"2026-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}