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Arch Dis Child Fetal Neonatal Ed 1999;81:F206-F207 doi:10.1136/fn.81.3.F206
  • Original article

Unexplained fever in neonates may be associated with hepatitis B vaccine

  1. Nehama Lindera,
  2. Meirav Razb,
  3. Lea Sirotaa,
  4. Brian Reichmanb,
  5. Dan Lubinb,
  6. Jacob Kuintb,
  7. Avner Herman Cohenc,
  8. Asher Barzilaic
  1. aDepartment of Neonatology Schneider Children’s Medical Center of Israel 14 Kaplan St Petah Tikva 49202 Israel, bDepartment of Neonatology Chaim Sheba Medical Center Tel Hashomer and the Sackler School of Medicine Tel Aviv University, cDepartment of Paediatric Infectious Diseases
  1. Dr N Linder.
  • Accepted 17 May 1999

Abstract

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.

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