Search

Fever is a common clinical complaint in adults and children with a variety of infectious illnesses, as well as a frequently reported adverse event following immunization. Although the level of measured temperature indicative of a "fever" was first defined in 1868, it remains unclear what role fever has as a physiologic reaction to invading substances, how best to measure body temperature and compare measurements from different body sites, and, consequently, how to interpret fever data derived from vaccine safety trials or immunization safety surveillance. However, even with many aspects of the societal, medical, economic, and epidemiologic meanings of fever as an adverse event following immunization (AEFI) still elusive, it is a generally benign-albeit common-clinical sign. By standardizing the definition and means of assessment of fever in vaccine safety studies, thereby permitting comparability of data, we hope to arrive at an improved understanding of its importance as an AEFI. [ABSTRACT FROM AUTHOR]

Presents a case scenario that illustrates the limitations of viral diagnosis. Medical condition of the patient; Suggestions for physicians; Information that need to be disseminated to parents.

Objectives: To review the potential benefits of pediatric combination vaccines to children, parents, providers, managed care organizations, and manufacturers and to discuss the scientific, social, and economic issues that need to be addressed to provide optimum uptake of these vaccines., Results: Combination vaccines provide multiple advantages for children, parents, and providers; however, their development involves considerable research and expense to ensure efficacy and safety. As the complexity of these vaccines increases, more extensive laboratory and clinical trials will be needed to ensure antigen compatibility, immunogenicity, and acceptable reactogenicity. To accommodate the large numbers of subjects necessary to establish vaccine efficacy and the absence of rare severe adverse events, revision of future licensure requirements may be necessary. Cost-benefit studies will be helpful in guiding pricing levels for manufacturers, efficient purchase plans for providers, and appropriate reimbursement policies for managed care organizations., Conclusions: The continued development and introduction of new combination vaccines offers significant potential benefits. Optimal uptake will require careful review of their many advantages and attention to potential problems perceived by those who will be affected by their use: manufacturers, children, parents, providers, and payers.