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Should paracetamol be taken before vaccination against COVID-19?

From Verificat, April 15

In its immunisation strategy, published on February 26, the Spanish sanitary authorities included paracetamol as a prophylactic treatment for the AstraZeneca/Oxford formulation, that is, as a preventive measure. According to the guidelines, this drug is used “to reduce the symptoms” that the vaccine can produce, “without causing an interference in the immune response”. In fact, the vaccine package leaflet itself states that once administered, local mild reactions can appear, as pain at the injection site, slight fever, chills, muscle pain, headache and malaise.

In this sense, the Spanish Society of Family and Community Medicine has recently published a statement advising against “systematically” dispensing paracetamol before the delivery of vaccines.

The Ministry recommendation is based on an study published on July 20, 2020 in the scientific journal The Lancet, when AstraZeneca was in the middle of clinical trials.

The Phase III results were published on November 23 and updated on March 22, 2021 and none of these reports states that one should take paracetamol before vaccination.

The document of the Spanish authorities also points that, “to date, only data about its use as prophylaxis for this vaccine have been published”. That is, there are no indications that one should take paracetamol before having a dose of the other approved vaccines in Europe: Pfizer/BioNTech, Moderna and Janssen (which has not yet started to be administered).

The United States advise against it

The Centers for Disease Control and Prevention (CDC) from the United States advise against taking prophylactic measures. In the European Medicines Agency (EMA), there is not any recommendation about the need of taking any kind of preventive medication before the vaccination and its press team has explained to Verificat in an email that it is not its competence to issue such recommendations.

Harvard University professor of medicine specialised in infectious diseases Paul Sax explains in the New England Medical Journal that “although the acetaminophen and the non-steroidal anti-inflammatory drugs can diminish the side effects, they can theoretically attenuate the immune response and make vaccines less effective, this is why they are not recommended prior to vaccination”. Nevertheless, he affirms that they “are useful to diminish the side effects once they appear”.

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