According to the report published in the Archives of Pediatrics and Adolescents Medicines,infants who receive pneumococcal conjugate vaccine(PCV) following the combination vaccine for diphtheria, polio, tetanus toxoids , acellular pertussis and Hemophilus influenza type b (DPTaP-Hib vaccine) experience significant less pain than other infants of same age who were immunized in the reverse order.
Moshe Ipp, M.B.B.Ch. FRCP(C), from The Hospital for Sick Children, in Toronto, Ontario, Canada and his colleagues studied 120 healthy infants 2 to 6 months of age undergoing routine immunizations at an outpatient pediatric clinic between July 21, 2006 and June 21, 2007. Fifty percent of infants received the PCV before the DPTaP-Hib vaccine, while fifty percent received the DPTaP-Hib vaccine first and then PCV. The entire process of immunization was videotaped and the intensity of pain was measured on modified behavioral pain scale (MBPS) that evaluated the infants’ facial expressions, crying and body movements after vaccination. Parents were also asked to rate their children’s pain level on a 10- cm visual analog scale (VAS).
The researchers opined that infants pain response during routine intramuscular vaccine injections was affected by the order of administration of the vaccine. Babies given the less painful DPTaP-Hib vaccine first accompanied by the more painful PCV experienced less pain overall when compared with those given the vaccines in the reverse order. In addition, pain increased from the first to second injection, irrespective of the order of vaccine injection.
These findings suggest that when two immunizations are given, the least painful vaccine should be given first, the author notes. Giving the more painful injection first may focus the infant’s attention on the process of vaccination and trigger off pain processing centers in the brain, resulting in more intense pain signal in response to any shots given afterwards.
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