Vital Signs - Childhood - Order of Vaccinations Helps With Pain - NYTimes.com; bottom line give dtap-hib first for decreasing pain, what is the reason?

Childhood: Order of Vaccinations Helps With Pain

By NICHOLAS BAKALAR

Published: May 11, 2009

The amount of pain infants feel when they undergo vaccinations may depend on the order in which the shots are given.

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Order of Vaccine Injection and Infant Pain Response (The Archives of Pediatrics and Adolescent Medicine)

Typically, infants receive DPTaP-Hib (for diphtheria, polio, pertussis, tetanus and Haemophilus influenzae Type B) and PCV (for pneumococcal disease) at the same visit. Researchers assigned 120 infants, average age 4 ½ months, to receive the two shots in random order.

The procedures were videotaped and scored for pain by independent observers on a 10-point scale that measured facial expression and body movement. Parents rated the infants’ pain using a 10-point scale from “no pain” to “worst possible pain.” Finally, the researchers noted the presence or absence of crying. The results appear in the May issue of The Archives of Pediatrics and Adolescent Medicine.

By all three measures — pain scale, parents’ observations and infants’ crying or not — giving the DPTaP-Hib vaccine first caused significantly less pain.

The lead author, Dr. Moshe Ipp of the University of Toronto, said that giving the shots in the right order was simple and effective. “It doesn’t cost anything,” he said, “and it’s easy to incorporate into a doctor’s practice.”

via nytimes.com

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