Comparison of distress and pain in infants randomized to groups receiving standard versus multiple immunizations.
Author(s): Hanson D, Hall W, Mills LL, Au S, Bhagat R, Hernandez M, Slomba N, Ali R
Affiliation(s): Vancouver Coastal Health, Pacific Spirit Health Centre, 2110 West 43rd Avenue, Vancouver, BC V6M 2E1, Canada.
Publication date & source: 2010-06, Infant Behav Dev., 33(3):289-96. Epub 2010 Apr 1.
Publication type: Comparative Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
This randomized controlled trial compared distress and pain in healthy 4-month-old infants receiving three different immunizations either sequentially (control, n=50) or simultaneously, two at the same time, followed by the third (experimental, n=51). Although both groups demonstrated a significant increase in cortisol from baseline levels, the lack of significant difference on salivary cortisol between groups post-immunization suggests the study was underpowered. On NIPS scores, the experimental group demonstrated significantly less pain (Mann-Whitney U=1648.0, p=0.003). Simultaneous injections appeared to be effective in reducing pain behavior responses in infants receiving their 4-month immunizations. Longitudinal studies could determine whether reduced exposure to pain in infancy, through simultaneous immunization injections, could contribute to a reduction in sensitivity to pain and physiologic stress responses. Copyright 2010 Elsevier Inc. All rights reserved.