Flu vaccine antibody response in infants is weakened by Tylenol (acetaminophen) also latest recalls

November 21, 12:09 PMSacramento Nutrition ExaminerAnne Hart

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According to the latest November 19, 2009 report, "Tylenol Found to Reduce Effectiveness of Vaccines," Rochester, NY: Tylenol, a medicine cabinet staple in millions of households, has been linked in the past to acetaminophen toxicity, potential liver damage, and other Tylenol side effects, and now there has been another Tylenol recall. 

Today, Johnson & Johnson (J&J) has recalled the product identified as Tylenol Arthritis Pain Caplets after consumers reported that the pills made them nauseous and had an uncharacteristic smell and taste. Five lots of the caplets, shipped in 100-count bottles with red EZ-Open caps, are being recalled voluntarily, according to a statement issued on November 6 by McNeil Consumer Healthcare, a unit of J&J. A report by the Newark-based Star-Ledger suggests that contamination could be linked to the wooden pallets on which empty bottles were shipped.

Last month a new study found that Tylenol may reduce the effectiveness of vaccines given to infants. Meanwhile, parents who administer acetaminophen to infants within the first day of their receiving a vaccination against viruses such as H1N1 could diminish the effectiveness of the vaccine, according to the November 11 edition of the Rochester Democrat and Chronicle.

Will a child or infant develop side effects from taking fever-reducing medicine after getting a vaccination? The study's conclusion focused on the evidence that acetaminophen interferes with the vaccine. A new study reported, according to the article, Prophylactic Acetaminophen Before Vaccination in Infants Reduces Vaccine Response, "fewer people are recommending routine use of Tylenol," according to an October 17, 2009 study published in The Lancet, Prophylactic acetaminophen during vaccination reduces antibody response.

Also see the study, Lancet. 2009;374:1305-1306, 1339-1350. GlaxoSmithKline Biologicals funded the study. See the article, "Tylenol May Weaken Infant Vaccines: Acetaminophen Linked to Poorer Immune Response to Infant Vaccines," published in MedScape Today, Oct. 16, 2009.

When family members give infants acetaminophen (paracetamol) and similar over-the-counter medicines such as Tylenol or any other type of acetaminophen to reduce fever or febrile convulsions after an infant is vaccinated, the result is reduced immunogenicity. That is, the pill or powder used to reduce fever reduces the ability of the flu vaccine to protect the child, according to The Lancet's latest study.

What happens is that a fever is part of a normal response of a baby to the frequent inflammation caused by immunization. Up until the latest study in The Lancet, most doctors prescribed drugs to reduce the fever and inflammation which often resulted in febrile convulsions when babies are immunized. These medicines are called in medical terms, "prophylactic antipyretic drugs."

Doctors often gave babies acetaminophen when parents rushed into medical offices after children were vaccinated and showed a fever of convulsions, likely caused as what doctors are calling a normal or common response to vaccination, including flu vaccination. It's the body's response to inflammation caused by the vaccination, which is part of the immune response.

According to the study, the drugs sometimes given to calm the parent's worry over a child's high fever and convulsion are actually ineffective in preventing febrile convulsions in children at risk. What the study found out is that the level of fever, that is how high the fever is, is unrelated to the onset of convulsions.

The purpose of the study focused on assessing the effect of acetaminophen on infant febrile reaction rates and vaccine responses.

Vaccination Studies Performed with Several Different Vaccines Given to Infants

According to the article, "Prophylactic Acetaminophen Before Vaccination in Infants Reduces Vaccine Response," published in the October 16, 2009 issue of Medscape Today, the authors performed 2 consecutive (primary and booster) vaccination open-label studies. Healthy infants aged 9 to 16 weeks were randomly assigned to receive 3 prophylactic acetaminophen doses every 6 to 8 hours in the first 24 hours (n = 226 infants) or to no acetaminophen (n = 233 infants) after each vaccination with a 10-valent pneumococcal nontypeable Haemophilus influenzae protein D-conjugate vaccine (PHiD-CV) coadministered with the hexavalent diphtheria-tetanus-3-component acellular pertussis-hepatitis B-inactivated poliovirus types 1, 2, and 3-H influenzae type b (DTPa-HBV-IPV/Hib) and oral human rotavirus vaccines.

In the study, the acetaminophen (called prophylactic acetaminophen) actually reduced the febrile reactions. But the findings were unexpected. Investigators were surprised to find that the medicine used to reduce fever also reduced the antibody response to the vaccines. 

What the Study Found

Antibodies after vaccination were reduced, according to the study. Results of the study revealed a substantial reduction in the primary antibody response to each of the 10 pneumococcal conjugate vaccine serotypes and to Hib polysaccharide, diphtheria, tetanus, and pertactin antigens. "After boosting, lower antibody GMCs persisted in the prophylactic...[acetaminophen] group for antitetanus, protein D, and all pneumococcal serotypes except for 19F," the study authors noted.

The actual method of the study began with children who had developed fever after vaccination with the most common childhood vaccinations. According to the study, "The percentage of children with a temperature of 38ºC or greater after at least 1 dose was significantly lower in the prophylactic acetaminophen group after primary vaccination (94/226; 42%) and after booster (64/178; 36%) vs the no-prophylactic acetaminophen group after primary vaccination (154/233; 66%) and after booster (100/172; 58%). Fever greater than 39.5ºC was uncommon in both groups."

After immunization antibody responses to acetaminophen had not been documented before

Few published studies have measured the effects of antipyretic drugs on child vaccine responses, according to the investigators. The study needs further testing. However, the physicians and scientists doing the study suggest that doctors should no longer routinely give babies acetaminophen without weighing the benefits against the risks of reducing the power of the vaccine to protect the child against the specific disease for which the child is being vaccinated. The study found that the drug after vaccination reduces immunity, as well as the baby's ability to create antibodies.

Doctors use medical terms to say don't give the medicine acetaminophen routinely. The study reports that the relevance of the findings is unknown right now and needs further testing. The medical terms suggest "prophylactic administration of antipyretic drugs at vaccination time should not be routinely recommended.

Are antibody concentrations reduced by taking fever-reducing medicines after vaccinations for adults and children as well as infants?

Studies such as this one are all about weighing benefits against risks. According to the CDC, the study raises a question. The result of the study showed reduced antibody concentrations in the infant's blood with the use of acetaminophen. When it comes to all types of vaccinations, including flu vaccinations with babies as well as adults, the question remains, according to the CDC, are antibody concentrations reduced with the use of acetaminophen, such as Tylenol and other medicine brands and generics with similar ingredients?

Does taking acetaminophen after vaccination reduce population protection? With the flu vaccine, it takes about three weeks for immunity to develop. If you come down with fever, headache, body aches, or any other response to vaccination for the flu or any other type of disease and  you take a pill such as Tylenol or other brands of acetaminophen, will it reduce the power of the vaccine to give protection against the disease it's supposed to protect you against? That's the important question. And that's why more studies are needed.

The study also revealed that when you take a vaccination for the flu or you get a pneumonia protection shot. Those vaccinations, flu and pneumonia shots, only work when your concentration of antibodies develop at a high enough rate to stop the carrier state and reduce transmission of the diseases in the population.

If people are popping acetaminophen pills or giving fever reducing medicines to their children, including infants after a vaccination, the medicine could reduce the number of antibodies created, reduce the immunity, and wipe out the benefits of the vaccination in protecting you against the disease.

The study focused on the reduced immunity resulting from pediatric vaccination programs that routinely prescribe acetaminophens. How many other medicines or even neutraceutical supplements taken after vaccinations also affect the number of antibodies you develop or influence whether immunity develops or is reduced or halted by taking certain medicines or even supplement combinations? That's why further testing is needed to find out exactly what reduces immunity when taken after a vaccination--before the immunity develops, considering it takes at least three weeks for flu immunity to develop after vaccination? 

One one side you have doctors telling parents that today's vaccines are safer than vaccines produced in the 1950s or 1970s. On the other side you have doctors telling parents that medicines given to babies to reduce fever after vaccinations may also reduce the potency of the shot to protect and give immunity to the child for that particular disease.

After all, the medicines given for infant vaccinations don't do much to reduce fever or quiet pain, according to the study. Previously doctors believed the over-the-counter or prescribed medicines helped infants after vaccinations. The study revealed how little those acetaminophen drugs actually do when routinely given to infants after vaccinations.

Think of the outcome. If the protective antibodies are lowered in society by people, including infants, getting medicine after vaccinations to lower fever, convulsions, or other side effects of the normal response to inflammation after vaccination needed to create immunity by increasing antibodies, will there be health concerns with people continuing to get the disease inspite of the vaccination?

The study needs to find out how much the amount of protective antibody is lowered and for some or all vaccines? Will people keep carrying the organism? If you're an infant vaccinated with a live virus, will you become a carrier of the virus and keep giving it to others but not getting sick with it yourself like a sort of turn of the century typhoid Mary? No one knows.

That's why research much continue to find out what happens when a baby is vaccinated, has some immunity, but reduced immunity, and then, perhaps, becomes a carrier of the disease, whatever it might be, passing it on to others in society. The disease could be the flu or some other disease infants are vaccinated against. This might not mean much.

Or it might mean the baby becomes a carrier of the disease without getting sick. No one knows at this point whether the infant with reduced immunity will continue to harbor the live virus over a lifetime, infecting others without getting sick. But so far, there have not been any reports of babies with reduced immunity caused by fever medicines after vaccinations passing a virus into society at large.

Some doctors will keep giving prophylactic acetaminophen. Of course, it's an option to be considered in case a child has a severe reaction after being vaccinated. All the study has shown is that there are reduced protective antibodies with acetaminophen.

If you work for the industry, you'll know that acetaminophen actually is given and will continue to be given by doctors when babies and children develop fevers and feel very uncomfortable. The bottom line of this study is use common sense. Ask your doctor whether drugs are really necessary after your baby is vaccinated.

According to the MSNBC article online, "Giving babies Tylenol may blunt vaccine effects: Finding knocks common advice for parents looking to curb fever after shots," the original study, which was led by military and government scientists in the Czech Republic at 10 medical centers in that Eastern European country. It involved 459 healthy infants, 9 to 16 weeks old, that received vaccines against polio, pneumonia, meningitis, whooping cough, tetanus, hepatitis and other childhood diseases.

The CDC doctors also point out that even with the fever-lowering drugs, more than 90 percent of children in the Czech study achieved protection from the various vaccines after the booster dose, so the effect of lower levels of antibodies on any individual might be small.

On the other hand, when immunity is reduced and the virus stays in the someone's body for a lifetime, scientists want to ask the question whether that person becomes a carrier of the virus, able to infect others, but not getting sick. Of course, it's a question that can only be answered by scientists testing to find out the answer. It's something to think about and, if you're a scientist, to investigate.

Resources

Study: Avoid Tylenol After Vaccinations - CBS News

Tylenol Found to Reduce Effectiveness of Vaccines « All Bronx News ...

Study: Avoid Tylenol After Vaccinations - (ap) - WKRG.com

Risks of Tylenol With a Baby's Swine Flu Shot: Acetaminophen ...

Tylenol lowers vaccine efficiency in kids

Giving babies Tylenol may blunt vaccines' effects - WQOW TV: Eau ...

Tylenol may blunt baby's vaccines | 6abc.com - 10/16/09 ...

Tylenol Recall 2009: List of Infant and Children's Tylenol Recall ...

Tylenol.com — News About Children's Cold Medicines

Recalled Infant and Children's Tylenol List

Tylenol, Inc. Children's and Infant's Recall List

Study: Giving Babies Tylenol Before Vaccinations May Make Shots ...