# Adverse Effect of Vaccination - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - 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 - Verified date: 2026-08 ## 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 ## Treatment metadata - Paracetamol — 500 mg — oral.solid - Ibuprofen — 400 mg — oral.solid - Adrenaline — injection ## Complete treatment card ```text ADVERSE EFFECT OF VACCINATION 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 against 3 sources listed above (2026-08) 1. PARACETAMOL [1st line] Adult 1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever Peds 15 mg/kg/dose [child max 500 mg] (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.) 3kg -> 45 mg/dose 4kg -> 60 mg/dose 5kg -> 75 mg/dose 6kg -> 90 mg/dose 7kg -> 105 mg/dose 8kg -> 120 mg/dose 9kg -> 135 mg/dose 10kg -> 150 mg/dose 11kg -> 165 mg/dose 12kg -> 180 mg/dose 13kg -> 195 mg/dose 14kg -> 210 mg/dose 15kg -> 225 mg/dose 16kg -> 240 mg/dose 17kg -> 255 mg/dose 18kg -> 270 mg/dose 19kg -> 285 mg/dose 20kg -> 300 mg/dose 21kg -> 315 mg/dose 22kg -> 330 mg/dose 23kg -> 345 mg/dose 24kg -> 360 mg/dose 25kg -> 375 mg/dose 26kg -> 390 mg/dose 27kg -> 405 mg/dose 28kg -> 420 mg/dose 29kg -> 435 mg/dose 30kg -> 450 mg/dose 31kg -> 465 mg/dose 32kg -> 480 mg/dose 33kg -> 495 mg/dose 34kg -> 500 mg/dose (capped) 35kg -> 500 mg/dose (capped) 36kg -> 500 mg/dose (capped) 37kg -> 500 mg/dose (capped) 38kg -> 500 mg/dose (capped) 39kg -> 500 mg/dose (capped) 40kg -> 500 mg/dose (capped) 41kg -> 500 mg/dose (capped) 42kg -> 500 mg/dose (capped) 43kg -> 500 mg/dose (capped) 44kg -> 500 mg/dose (capped) 45kg -> 500 mg/dose (capped) 46kg -> 500 mg/dose (capped) 47kg -> 500 mg/dose (capped) 48kg -> 500 mg/dose (capped) 49kg -> 500 mg/dose (capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why First-line symptomatic relief for the common mild fever or soreness that follows vaccination; paracetamol dosing is unchanged by the trigger for the fever. Caution 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. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid 2. IBUPROFEN [2nd line] Adult 200-400 mg PO Q6-8H PRN, max 1200 mg/day. Peds Age 3m+: 20-30 mg/kg/day divided Q6-8H PRN. (Dosed by age bands on liquid suspension labels). Source SmPC section 4.2, https://www.medicines.org.uk/emc/product/4560/smpc Why 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. Caution 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. Egypt DAJUANOFEN 400 MG 20 F.C. TABS. COPAD PHARMA 5.00 EGP (0.25/unit) FLABU 400MG 10 F.C.TAB. DELTA PHARMA 3.75 EGP (0.38/unit) NOVA-PROFEN 400MG 30 F.C. TABLETS SANOFI 12.75 EGP (0.42/unit) IBUPROFEN 400 MG 10 TAB. SEDICO 6.00 EGP (0.60/unit) MAFO 400 MG 30 F.C.TABS EIPICO 42.00 EGP (1.40/unit) BRUFEN 400 MG 30 TABS. KAHIRA > ABBO... 78.00 EGP (2.60/unit) PROFUSOL 400MG 20 S.G CAPS. EUROPEAN EGYP... 31.00 EGP ANALGIPROF 400 MG 25 SACHETS EVA PHARMA 37.50 EGP NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML SANOFI 2.25 EGP -> ? strength differs, ? different route - not oral solid BRUFEMOL-N SUSP. 60 ML ARAB DRUG COM... 4.50 EGP -> ? strength differs, ? different route - not oral solid 3. ADRENALINE [3rd line] Adult 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. - Emergency dose, repeat at 5 min PRN Peds Under 6 months: 100 to 150 mcg (0.1 to 0.15 mL) IM. Repeat after 5 minutes if no improvement. 6 months to 5 years: 150 mcg (0.15 mL) IM. Repeat after 5 minutes if no improvement. 6 to 11 years: 300 mcg (0.3 mL) IM. Repeat after 5 minutes if no improvement. 12 years and over: 500 mcg (0.5 mL) IM - give 300 mcg if the child is small or prepubertal. Repeat after 5 minutes if no improvement. (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.) Source Resuscitation Council UK Anaphylaxis Guidelines 2021 Why 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. Caution 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. Egypt EPINEPHRINE-MEMPHIS 1 MG/ML 5 I.M./S.C. AMP. MEMPHIS 10.00 EGP ADRENAMAX 1 MG/1ML 10 AMPS. CHEMIPHARM 75.00 EGP EPINEPHRINE-MISR 0.25 MG/ML 25 AMP. MISR 187.50 EGP EPINEPHRINE-MISR 1 MG/ML 100 AMP. MISR 750.00 EGP ADRENALINE-CID 1 MG/1ML 100 I.M./S.C. AMP. CID 850.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)