The annual influenza vaccine is very successful, although it might induce side effects, causing some people to use preventive antipyretic analgesics such as acetaminophen or NSAIDs. However, data from pediatric trials shows that taking these drugs close to the time of vaccination may reduce the body's immunological response, possibly by blocking inflammatory pathways.
While post-vaccination usage has been extensively investigated, results for adult influenza vaccinations are varied and restricted. To fill a vacuum in the literature, this post-hoc analysis of a four-year randomized controlled study examines how prevaccination analgesic usage affects influenza vaccine immunogenicity and efficacy in adults, with the goal of informing future therapeutic recommendations.
The efficacy of FDA-licensed influenza vaccinations across four influenza seasons in adult military healthcare beneficiaries was assessed in the open-label, randomized Pragmatic Assessment of Influenza Vaccine Effectiveness in the DoD (PAIVED) research. This study comprised PAIVED individuals who had data on analgesic usage within 24 hours prior to vaccination, submitted venous blood samples prior to and following immunization, or took part in weekly ILI monitoring.
10.4% (n = 71) of the 684 PAIVED participants with prevaccination and postvaccination antibody titers reported using analgesics prior to influenza vaccination.
Geometric mean titer fold change and analgesic usage did not correlate, according to multivariable analysis.
When compared to no analgesic usage, there was a slight correlation (aIRR = 1.37; P =.022) between acetaminophen use and higher seroconversion to influenza A/H3N2; but this correlation was not significant in sensitivity analyses that adjusted for multiple comparisons.
10.6% (n = 1140) of the 10,723 PAIVED participants with ILI monitoring data reported using analgesics prior to immunization.
Analgesic usage did not correlate with the incidence of ILI or the likelihood of contracting influenza, according to multivariable analyses.
Overall, pre-vaccination analgesic usage is not linked to decreased immunogenicity or efficiency of the influenza vaccine, according to this investigation. When advising patients on the use of analgesics before receiving an influenza vaccine, medical professionals may use a customized approach.
Reference:
Skellington, C. N., Schmidt, K., Schofield, C., Ganesan, A., Lalani, T., Mende, K., Saperstein, A., Williams, A., Larson, D., McClenathan, B., Housel, L. A., Seshadri, S., Fries, A. C., Tilley, D. H., Pollett, S. D., Burgess, T. H., Richard, S. A., & Colombo, R. E. (2026). The effect of prevaccination analgesics on influenza vaccine immunogenicity and effectiveness. The Journal of Infectious Diseases, jiag334. https://doi.org/10.1093/infdis/jiag334
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