{ "schema_version": 1, "kind": "condition", "id": "vaccine-adverse-effect", "name": "Adverse Effect of Vaccination", "category": "acute", "sources": "Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · MSF Essential Drugs 2024 - paracetamol (oral) · Resuscitation Council UK Anaphylaxis Guidelines 2021", "review_status": "reviewed", "verified_against": "MSF Essential Drugs 2024 - paracetamol (oral) · Resuscitation Council UK Anaphylaxis Guidelines 2021 · SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc", "verified_date": "2026-08", "treatments": [ { "id": 1853, "generic": "Paracetamol", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "1 g three or four times daily, maximum 4 g in 24 hours", "adult_duration": "As needed for pain or fever", "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)", "rationale": "First-line symptomatic relief for the common mild fever or soreness that follows vaccination; paracetamol dosing is unchanged by the trigger for the fever.", "cautions": [ "Simple antipyretic/analgesic for the common mild fever, injection-site soreness, or malaise after vaccination; not evidence of infection.", "Seek care if fever is very high, persists beyond 48 hours, or the patient becomes unusually drowsy or inconsolable.", "Do not exceed 4 g in 24 hours; caution in liver impairment.", "RED FLAG - Stridor, facial swelling, or hypotension within minutes of vaccination needs adrenaline immediately, which is why vaccination sites should observe patients for 15-30 minutes; high fever, seizure, or persistent inconsolable crying or lethargy in an infant after vaccination needs referral for assessment." ], "peds_mgkg_low": 15.0, "peds_mgkg_high": 15.0, "peds_max_mg": 500.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 150, "high_mg": 150, "capped": false }, { "weight_kg": 20, "low_mg": 300, "high_mg": 300, "capped": false }, { "weight_kg": 30, "low_mg": 450, "high_mg": 450, "capped": false }, { "weight_kg": 40, "low_mg": 500, "high_mg": 500, "capped": true } ], "brands": [ { "trade_name": "FEBRIMOL 500 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 3.5, "pack_count": 20, "unit_price": 0.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAMOL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 8.0, "pack_count": 20, "unit_price": 0.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARACETAMOL-MUP 500MG B.P. 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 13.0, "pack_count": 20, "unit_price": 0.65, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CETAL 500 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 24.0, "pack_count": 20, "unit_price": 1.2, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ARKADOLOW 500 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UTOPIA", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PARAMOL 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 38.0, "pack_count": 20, "unit_price": 1.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADOL 500MG 24 CAPLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AUGICETAMIDE 500 MG 20 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AUG PHARMA", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FEBRIMOL ORAL DROPS 20 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 3200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "vaccine-adverse-effect" }, { "id": 1854, "generic": "Ibuprofen", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "200-400 mg PO Q6-8H PRN, max 1200 mg/day.", "adult_duration": null, "dose_source": "SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc", "rationale": "General-purpose antipyretic/analgesic dose that applies equally to the fever and myalgia of a vaccine reaction; not the higher anti-inflammatory regimen needed for a true inflammatory illness.", "cautions": [ "Alternative or add-on to paracetamol for vaccine-related fever, myalgia, or arm soreness.", "Avoid in known NSAID-exacerbated asthma, active peptic ulcer disease, dehydration, or third-trimester pregnancy.", "Take with or after food." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Age 3m+: 20-30 mg/kg/day divided Q6-8H PRN. (Dosed by age bands on liquid suspension labels).", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DAJUANOFEN 400 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "COPAD PHARMA", "price_egp": 5.0, "pack_count": 20, "unit_price": 0.25, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLABU 400MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 3.75, "pack_count": 10, "unit_price": 0.38, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 400MG 30 F.C. TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 12.75, "pack_count": 30, "unit_price": 0.42, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 400 MG 10 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 6.0, "pack_count": 10, "unit_price": 0.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MAFO 400 MG 30 F.C.TABS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 42.0, "pack_count": 30, "unit_price": 1.4, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 400 MG 30 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 78.0, "pack_count": 30, "unit_price": 2.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROFUSOL 400MG 20 S.G CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 31.0, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANALGIPROF 400 MG 25 SACHETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 37.5, "pack_count": null, "unit_price": null, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "vaccine-adverse-effect" }, { "id": 1855, "generic": "Adrenaline", "line": 3, "is_adjunct": false, "form": "injection", "strength_mg": null, "adult_dose": "0.5 mg (0.5 mL of 1:1000 / 1 mg/mL solution) INTRAMUSCULARLY into mid-outer thigh. Repeat every 5 minutes PRN if no improvement.", "adult_duration": "Emergency dose, repeat at 5 min PRN", "dose_source": "Resuscitation Council UK Anaphylaxis Guidelines 2021", "rationale": "The emergency dose for vaccine-triggered anaphylaxis, the one genuinely dangerous adverse effect of vaccination; unrelated to the mild fever/soreness the other two drugs treat.", "cautions": [ "Reserved for the rare true anaphylactic reaction to a vaccine component - stridor, facial/lip swelling, wheeze, or hypotension within minutes of vaccination.", "Give IM into the anterolateral thigh immediately; never IV in primary care - fatal arrhythmia risk.", "Call emergency services (123) and arrange urgent transport; observe vaccinated patients for 15-30 minutes on-site specifically to catch this." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Age-banded fixed doses (IM 1 mg/mL): < 6 months: 100-150 mcg (0.1-0.15 mL); 6 months to 6 years: 150 mcg (0.15 mL); 6 to 12 years: 300 mcg (0.3 mL); > 12 years: 500 mcg (0.5 mL) [give 300 mcg if child is small or prepubertal]. Repeat after 5 minutes if no improvement.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "Under 6 months", "age_min_months": 0, "age_max_months": 5, "dose_text": "100 to 150 mcg (0.1 to 0.15 mL) IM. Repeat after 5 minutes if no improvement." }, { "label": "6 months to 5 years", "age_min_months": 6, "age_max_months": 71, "dose_text": "150 mcg (0.15 mL) IM. Repeat after 5 minutes if no improvement." }, { "label": "6 to 11 years", "age_min_months": 72, "age_max_months": 143, "dose_text": "300 mcg (0.3 mL) IM. Repeat after 5 minutes if no improvement." }, { "label": "12 years and over", "age_min_months": 144, "age_max_months": 216, "dose_text": "500 mcg (0.5 mL) IM - give 300 mcg if the child is small or prepubertal. Repeat after 5 minutes if no improvement." } ], "peds_doses": null, "brands": [ { "trade_name": "EPINEPHRINE-MEMPHIS 1 MG/ML 5 I.M./S.C. AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 10.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADRENAMAX 1 MG/1ML 10 AMPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CHEMIPHARM", "price_egp": 75.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPINEPHRINE-MISR 0.25 MG/ML 25 AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 187.5, "pack_count": null, "unit_price": null, "strength_mg": 0.25, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPINEPHRINE-MISR 1 MG/ML 100 AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 750.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADRENALINE-CID 1 MG/1ML 100 I.M./S.C. AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 850.0, "pack_count": null, "unit_price": null, "strength_mg": 1.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "vaccine-adverse-effect" } ] }