Unexplained fever in neonates may be associated with hepatitis B vaccine

October 19, 1999

Arch Dis Child Fetal Neonatal Ed 1999;81:F206-F207 ( November )

Nehama Lindera, Meirav Razb, Lea Sirotaa, Reichmanb, Dan Lubinb,

Kuintb, Avner Herman Cohenc, Asher Barzilaic

a Department of Neonatology Schneider Children's Medical Center of Israel 14

Kaplan St Petah Tikva 49202 Israel, b Department of Neonatology Chaim Sheba

Medical Center Tel Hashomer and the Sackler School of Medicine Tel Aviv

University, c Department of Paediatric Infectious Diseases

Correspondence to: Dr N Linder.

Accepted 17 May 1999

AIM:To investigate whether hepatitis B vaccination has increased the number

of cases of unexplained neonatal fever.

METHOD:The files of all infants born from 1 January 1991 to 31 December 1992,

in whom a diagnosis of " injected antibiotic " or " disease of temperature

regulation " was recorded, were reviewed. Those who had unexplained fever of

38°C or higher during the first three days of life were divided into two

groups: infants who did not receive the hepatitis B vaccine (1991) and

infants who did (1992).

RESULTS:In 1992 the incidence of unexplained fever in hepatitis B vaccinated

neonates was significantly higher than in the 1991 group of pre-vaccination

neonates (35 out of 5819 (0.6%) vs 14 out of 5010 neonates (0.28%)

respectively, p=0.013).

CONCLUSIONS:The increase in the number of cases of unexplained neonatal fever

seems to be associated with the introduction of routine hepatitis B

vaccination on the first day of life. The possibility that an excess number

of neonates will undergo unnecessary procedures and treatment to diagnose

unexplained fever justifies planning a controlled study to determine whether

these preliminary findings point to a significant problem.

Keywords: hepatitis B vaccine; fever

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