An Infant Presenting With Fever After First Set Of Immunization

A 2 month old infant is brought to your clinic with a history of having developed temperature of   39.9 C following his first set of immunization. The child is screaming and irritable. General and systemic examination shows no abnormality.
Answer the following questions:

1. Which immunization(s) is/(are) the most likely cause of fever and irritability in the child and outline initial steps in management?
2. What modifications will you make in the immunization schedule for this child?


Answers:

1. Which immunization(s) is/(are) the most likely cause of fever and irritability in the child and outline initial steps in management?

Answer: The DPT ( diptheria, pertussis, tetanus) vaccine is most likely to cause the fever and irritability in this child.
Management: Mild fever is common in children after immunization but it is important to rule out any serious side effects. In this case take a detailed history and ask about any seizures, loss of consciousness and vomiting. A temperature  above 105 F is considered to be an alarming sign.
The infant should be give baby paracetamol every 4 hourly and should be observed closely. The parents should be explained about the danger signs and to report in emergency immediately if the child appears lethargic or difficult to wake, had fits/seizures, if the fever does not respond to paracetamol.

2. What modifications will you make in the immunization schedule for this child?

Answer: The child should be given DaPT ( diptheria, acellular pertussis and tetanus vaccine ) the next time. Also a dose of paracetamol can be given before the next immunization shot.