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Thursday, January 27, 2022

Paracetamol after Covid-19 vaccine: Only if doctor advises it

🔴 Like any vaccine, Covid-19 vaccines can cause side effects, most of which are mild or moderate and go away within a few days.

Written by Anuradha Mascarenhas | Pune |
Updated: January 8, 2022 11:05:23 am
A beneficiary gets vaccinated by a health worker at Rajawadi Hospital in Mumbai. (Express Photo: Amit Chakravarty)

On Wednesday, Hyderabad-based manufacturer Bharat Biotech, whose vaccine Covaxin is being administered to adolescents, said no paracetamol or painkillers are recommended after being vaccinated with Covaxin.

Like any vaccine, Covid-19 vaccines can cause side effects, most of which are mild or moderate and go away within a few days. While many may feel tempted to use a painkiller or paracetamol, experts advise against routine use of these.

In a tweet, Bharat Biotech said, “We have received feedback that certain immunisation centres are recommending taking three paracetamol 500 mg tablets along with Covaxin for children. No paracetamol or painkillers are recommended after being vaccinated with Covaxin.”

It said that through its clinical trials on 30,000 individuals, about 10-20% reported side effects. “Most were mild and resolved within one or two days and do not require medication. Medication is only recommended in consultation with a physician,” it said.

A company spokesperson quoted a study published in The Lancet in November 2021 which said that Covaxin has been well tolerated . “Unless specifically recommended by doctors for certain recipients, paracetamol is not required.” The spokesperson said based on data available from studies in adults and trials in children (2-18 years), the measured adverse events were similar to other inactivated vaccines and much lower than vaccines using other platforms.

The reasoning

“Basically, one can make better antibody responses if there is a bit of inflammation. If one gives an anti-inflammatory drug immediately after vaccination, then antibody response may be less. There are studies that have documented giving paracetamol or any other anti-inflammatory drug immediately after vaccination will suppress the immune response a little bit,” leading immunologist Dr Gagandeep Kang said.

Dr Sanjay Pujari, member of the Indian Council of Medical Research (ICMR) national task force for Covid-19, said side effects from vaccines are not very frequent, and are mostly mild, resolving within 1-2 days. It is not known how drugs like paracetamol and other anti-inflammatories might affect how well the vaccine works. Hence routine use of these drugs either before or after taking vaccines is not advisable, he said.

Children and paracetamol

Paediatrician Dr Umesh Vaidya, regional medical director (West) Cloudnine Hospitals, said: “Unless there is fever beyond a particular temperature, paracetamol is not routinely given.” He said children tolerate vaccines much better than adults . About paracetamol, he said: “This drug has been in use in children for more than 100 years. It is the safest medicine in paediatrics. So there is no harm in giving paracetamol for any local or systemic febrile reaction post vaccination.”

According to infectious diseases consultant Dr Amit Dravid, in children there could be concern about hepatotoxicity of paracetamol. It is a liver toxic drug. Hence it should not be a blanket rule and the drug should only be administered if there are symptoms post vaccination.

Why side effects

Side effects from the vaccine are a normal sign that the body is building protection. These may affect one’s ability to do daily activities but mostly go away in a few days. Some people have no side effects and allergic reactions are rare, according to a December 16 , 2021 update from the US Centers for Disease Control and Prevention (CDC).

Common side effects are pain, redness, swelling, headache, muscle pain, fever and nausea. The CDC says one needs to talk to a doctor for taking over-the-counter medicine such as ibuprofen, acetaminophen, aspirin (only for people age 18 and above) or antihistamines for any pain and discomfort experienced after getting vaccinated. It is not recommended to take medicines before vaccination hoping to avoid side effects. According to the CDC, it is not known how these medications might affect how well the vaccine works. However if the medications are regularly taken for other reasons they should be taken before vaccination.

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