drugset / Trial / NCT02807623
Do NSAIDS or Executing Exercise Decrease Local Erythema, Site Swelling & Pain After INoculation
RandomizedParallel-groupTriple-blindPrevention
Summary
The purpose of this clinical investigation is to evaluate the efficacy and immunologic effects of a non-pharmacological exercise intervention (push-ups) compared to an oral NSAID (ibuprofen) and an oral placebo to decrease local injection site inflammation symptoms of delayed pain, erythema, and edema and any impact on serologic antibody immune response after influenza vaccine receipt.
Timeline
- Start
- 2016-09
- Primary completion
- 2018-12
- Completion
- 2018-12
Publications
- Background Abbott K, Fowler-Kerry S. The use of a topical refrigerant anesthetic to reduce injection pain in children. J Pain Symptom Manage. 1995 Nov;10(8):584-90. doi: 10.1016/0885-3924(95)00086-0.
- Background Abuelkheir M, Alsourani D, Al-Eyadhy A, Temsah MH, Meo SA, Alzamil F. EMLA(R) cream: a pain-relieving strategy for childhood vaccination. J Int Med Res. 2014 Apr;42(2):329-36. doi: 10.1177/0300060513509473. Epub 2014 Feb 5.
- Background Berberich FR, Landman Z. Reducing immunization discomfort in 4- to 6-year-old children: a randomized clinical trial. Pediatrics. 2009 Aug;124(2):e203-9. doi: 10.1542/peds.2007-3466. Epub 2009 Jul 13.
- Background Bruunsgaard H, Hartkopp A, Mohr T, Konradsen H, Heron I, Mordhorst CH, Pedersen BK. In vivo cell-mediated immunity and vaccination response following prolonged, intense exercise. Med Sci Sports Exerc. 1997 Sep;29(9):1176-81. doi: 10.1097/00005768-199709000-00009.
- Background Campbell JP, Edwards KM, Ring C, Drayson MT, Bosch JA, Inskip A, Long JE, Pulsford D, Burns VE. The effects of vaccine timing on the efficacy of an acute eccentric exercise intervention on the immune response to an influenza vaccine in young adults. Brain Behav Immun. 2010 Feb;24(2):236-42. doi: 10.1016/j.bbi.2009.10.001. Epub 2009 Oct 8.
- Background Chambers CT, Taddio A, Uman LS, McMurtry CM; HELPinKIDS Team. Psychological interventions for reducing pain and distress during routine childhood immunizations: a systematic review. Clin Ther. 2009;31 Suppl 2:S77-S103. doi: 10.1016/j.clinthera.2009.07.023.
- Background Cobb JE, Cohen LL. A randomized controlled trial of the ShotBlocker for children's immunization distress. Clin J Pain. 2009 Nov-Dec;25(9):790-6. doi: 10.1097/AJP.0b013e3181af1324.
- Background Cohen Reis E, Holubkov R. Vapocoolant spray is equally effective as EMLA cream in reducing immunization pain in school-aged children. Pediatrics. 1997 Dec;100(6):E5. doi: 10.1542/peds.100.6.e5.
- Background Das RR, Panigrahi I, Naik SS. The effect of prophylactic antipyretic administration on post-vaccination adverse reactions and antibody response in children: a systematic review. PLoS One. 2014 Sep 2;9(9):e106629. doi: 10.1371/journal.pone.0106629. eCollection 2014.
- Background Dilli D, Kucuk IG, Dallar Y. Interventions to reduce pain during vaccination in infancy. J Pediatr. 2009 Mar;154(3):385-90. doi: 10.1016/j.jpeds.2008.08.037. Epub 2008 Oct 11.
- Background Doedee AM, Boland GJ, Pennings JL, de Klerk A, Berbers GA, van der Klis FR, de Melker HE, van Loveren H, Janssen R. Effects of prophylactic and therapeutic paracetamol treatment during vaccination on hepatitis B antibody levels in adults: two open-label, randomized controlled trials. PLoS One. 2014 Jun 4;9(6):e98175. doi: 10.1371/journal.pone.0098175. eCollection 2014.
- Background Gidudu JF, Walco GA, Taddio A, Zempsky WT, Halperin SA, Calugar A, Gibbs NA, Hennig R, Jovancevic M, Netterlid E, O'Connor T, Oleske JM, Varricchio F, Tsai TF, Seifert H, Schuind AE; Brighton Immunization Site Pain Working Group. Immunization site pain: case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine. 2012 Jun 22;30(30):4558-77. doi: 10.1016/j.vaccine.2012.03.085. Epub 2012 Apr 18. No abstract available.
- Background Gidudu J, Kohl KS, Halperin S, Hammer SJ, Heath PT, Hennig R, Hoet B, Rothstein E, Schuind A, Varricchio F, Walop W; Brighton Collaboration Local Reactions Working Group for a Local Reaction at or near Injection Site. A local reaction at or near injection site: case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine. 2008 Dec 9;26(52):6800-13. doi: 10.1016/j.vaccine.2008.10.006. Epub 2008 Oct 23.
- Background Edwards KM, Booy R. Effects of exercise on vaccine-induced immune responses. Hum Vaccin Immunother. 2013 Apr;9(4):907-10. doi: 10.4161/hv.23365. Epub 2013 Jan 14.
- Background Edwards KM, Burns VE, Adkins AE, Carroll D, Drayson M, Ring C. Meningococcal A vaccination response is enhanced by acute stress in men. Psychosom Med. 2008 Feb;70(2):147-51. doi: 10.1097/PSY.0b013e318164232e. Epub 2008 Feb 6.
- Background Edwards KM, Burns VE, Allen LM, McPhee JS, Bosch JA, Carroll D, Drayson M, Ring C. Eccentric exercise as an adjuvant to influenza vaccination in humans. Brain Behav Immun. 2007 Feb;21(2):209-17. doi: 10.1016/j.bbi.2006.04.158. Epub 2006 Jul 7.
- Background Edwards KM, Burns VE, Reynolds T, Carroll D, Drayson M, Ring C. Acute stress exposure prior to influenza vaccination enhances antibody response in women. Brain Behav Immun. 2006 Mar;20(2):159-68. doi: 10.1016/j.bbi.2005.07.001. Epub 2005 Aug 15.
- Background Edwards KM, Campbell JP, Ring C, Drayson MT, Bosch JA, Downes C, Long JE, Lumb JA, Merry A, Paine NJ, Burns VE. Exercise intensity does not influence the efficacy of eccentric exercise as a behavioural adjuvant to vaccination. Brain Behav Immun. 2010 May;24(4):623-30. doi: 10.1016/j.bbi.2010.01.009. Epub 2010 Jan 25.
- Background Edwards KM, Pung MA, Tomfohr LM, Ziegler MG, Campbell JP, Drayson MT, Mills PJ. Acute exercise enhancement of pneumococcal vaccination response: a randomised controlled trial of weaker and stronger immune response. Vaccine. 2012 Oct 5;30(45):6389-95. doi: 10.1016/j.vaccine.2012.08.022. Epub 2012 Aug 22.
- Background Gleeson M, Pyne DB, McDonald WA, Clancy RL, Cripps AW, Horn PL, Fricker PA. Pneumococcal antibody responses in elite swimmers. Clin Exp Immunol. 1996 Aug;105(2):238-44. doi: 10.1046/j.1365-2249.1996.d01-752.x.
- Background Taddio A, Lord A, Hogan ME, Kikuta A, Yiu A, Darra E, Bruinse B, Keogh T, Stephens D. A randomized controlled trial of analgesia during vaccination in adults. Vaccine. 2010 Jul 19;28(32):5365-9. doi: 10.1016/j.vaccine.2010.05.015. Epub 2010 May 16.
- Background Hogan ME, Kikuta A, Taddio A. A systematic review of measures for reducing injection pain during adult immunization. Vaccine. 2010 Feb 10;28(6):1514-21. doi: 10.1016/j.vaccine.2009.11.065. Epub 2009 Dec 8.
- Background Irwin MR, Olmstead R, Oxman MN. Augmenting immune responses to varicella zoster virus in older adults: a randomized, controlled trial of Tai Chi. J Am Geriatr Soc. 2007 Apr;55(4):511-7. doi: 10.1111/j.1532-5415.2007.01109.x.
- Background Jackson LA, Dunstan M, Starkovich P, Dunn J, Yu O, Nelson JC, Rees T, Zavitkovsky A. Prophylaxis with acetaminophen or ibuprofen for prevention of local reactions to the fifth diphtheria-tetanus toxoids-acellular pertussis vaccination: a randomized, controlled trial. Pediatrics. 2006 Mar;117(3):620-5. doi: 10.1542/peds.2005-1217.
- Background Keylock KT, Lowder T, Leifheit KA, Cook M, Mariani RA, Ross K, Kim K, Chapman-Novakofski K, McAuley E, Woods JA. Higher antibody, but not cell-mediated, responses to vaccination in high physically fit elderly. J Appl Physiol (1985). 2007 Mar;102(3):1090-8. doi: 10.1152/japplphysiol.00790.2006. Epub 2006 Nov 9.
- Background Kohl KS, Walop W, Gidudu J, Ball L, Halperin S, Hammer SJ, Heath P, Hennig R, Rothstein E, Schuind A, Varricchio F; Brighton Collaboration Local Reactions Working Group for Induration at or near Injection Site. Induration at or near injection site: case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine. 2007 Aug 1;25(31):5839-57. doi: 10.1016/j.vaccine.2007.04.062. Epub 2007 May 8. No abstract available.
- Background Kohl KS, Walop W, Gidudu J, Ball L, Halperin S, Hammer SJ, Heath P, Varricchio F, Rothstein E, Schuind A, Hennig R; Brighton Collaboration Local Reaction Working Group for Swelling at or near Injection Site. Swelling at or near injection site: case definition and guidelines for collection, analysis and presentation of immunization safety data. Vaccine. 2007 Aug 1;25(31):5858-74. doi: 10.1016/j.vaccine.2007.04.056. Epub 2007 May 11. No abstract available.
- Background Kohut ML, Arntson BA, Lee W, Rozeboom K, Yoon KJ, Cunnick JE, McElhaney J. Moderate exercise improves antibody response to influenza immunization in older adults. Vaccine. 2004 Jun 2;22(17-18):2298-306. doi: 10.1016/j.vaccine.2003.11.023.
- Background Kohut ML, Cooper MM, Nickolaus MS, Russell DR, Cunnick JE. Exercise and psychosocial factors modulate immunity to influenza vaccine in elderly individuals. J Gerontol A Biol Sci Med Sci. 2002 Sep;57(9):M557-62. doi: 10.1093/gerona/57.9.m557.
- Background Kristjansdottir O, Kristjansdottir G. Randomized clinical trial of musical distraction with and without headphones for adolescents' immunization pain. Scand J Caring Sci. 2011 Mar;25(1):19-26. doi: 10.1111/j.1471-6712.2010.00784.x.
- Background Long JE, Ring C, Bosch JA, Eves F, Drayson MT, Calver R, Say V, Allen D, Burns VE. A life-style physical activity intervention and the antibody response to pneumococcal vaccination in women. Psychosom Med. 2013 Oct;75(8):774-82. doi: 10.1097/PSY.0b013e3182a0b664. Epub 2013 Aug 6.
- Background Long JE, Ring C, Drayson M, Bosch J, Campbell JP, Bhabra J, Browne D, Dawson J, Harding S, Lau J, Burns VE. Vaccination response following aerobic exercise: can a brisk walk enhance antibody response to pneumococcal and influenza vaccinations? Brain Behav Immun. 2012 May;26(4):680-7. doi: 10.1016/j.bbi.2012.02.004. Epub 2012 Feb 22.
- Background Maiden MJ, Benton GN, Bourne RA. Effect of warming adult diphtheria-tetanus vaccine on discomfort after injection: a randomised controlled trial. Med J Aust. 2003 May 5;178(9):433-6. doi: 10.5694/j.1326-5377.2003.tb05284.x.
- Background Manley J, Taddio A. Acetaminophen and ibuprofen for prevention of adverse reactions associated with childhood immunization. Ann Pharmacother. 2007 Jul;41(7):1227-32. doi: 10.1345/aph.1H647. Epub 2007 May 22.
- Background Mawhorter S, Daugherty L, Ford A, Hughes R, Metzger D, Easley K. Topical vapocoolant quickly and effectively reduces vaccine-associated pain: results of a randomized, single-blinded, placebo-controlled study. J Travel Med. 2004 Sep-Oct;11(5):267-72. doi: 10.2310/7060.2004.19101.
- Background Nakashima Y, Harada M, Okayama M, Kajii E. Analgesia for pain during subcutaneous injection: effectiveness of manual pressure application before injection. Int J Gen Med. 2013 Sep 25;6:817-20. doi: 10.2147/IJGM.S50125. eCollection 2013.
- Background Nilsson S, Forsner M, Finnstrom B, Morelius E. Relaxation and guided imagery do not reduce stress, pain and unpleasantness for 11- to 12-year-old girls during vaccinations. Acta Paediatr. 2015 Jul;104(7):724-9. doi: 10.1111/apa.13000. Epub 2015 Apr 22.
- Background Pascoe AR, Fiatarone Singh MA, Edwards KM. The effects of exercise on vaccination responses: a review of chronic and acute exercise interventions in humans. Brain Behav Immun. 2014 Jul;39:33-41. doi: 10.1016/j.bbi.2013.10.003. Epub 2013 Oct 11.
- Background Porter CK, Bowens MJ, Tribble DR, Putnam SD, Sanders JW, Riddle MS. Attitudes towards vaccines and infectious disease risk among U.S. troops. Hum Vaccin. 2008 Jul-Aug;4(4):298-304. doi: 10.4161/hv.4.4.5802. Epub 2008 Feb 27. No abstract available.
- Background Prymula R, Siegrist CA, Chlibek R, Zemlickova H, Vackova M, Smetana J, Lommel P, Kaliskova E, Borys D, Schuerman L. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet. 2009 Oct 17;374(9698):1339-50. doi: 10.1016/S0140-6736(09)61208-3.
- Background Ranadive SM, Cook M, Kappus RM, Yan H, Lane AD, Woods JA, Wilund KR, Iwamoto G, Vanar V, Tandon R, Fernhall B. Effect of acute aerobic exercise on vaccine efficacy in older adults. Med Sci Sports Exerc. 2014 Mar;46(3):455-61. doi: 10.1249/MSS.0b013e3182a75ff2.
- Background Rose MA, Juergens C, Schmoele-Thoma B, Gruber WC, Baker S, Zielen S. An open-label randomized clinical trial of prophylactic paracetamol coadministered with 7-valent pneumococcal conjugate vaccine and hexavalent diphtheria toxoid, tetanus toxoid, 3-component acellular pertussis, hepatitis B, inactivated poliovirus, and Haemophilus influenzae type b vaccine. BMC Pediatr. 2013 Jun 21;13:98. doi: 10.1186/1471-2431-13-98.
- Background Russell K, Nicholson R, Naidu R. Reducing the pain of intramuscular benzathine penicillin injections in the rheumatic fever population of Counties Manukau District Health Board. J Paediatr Child Health. 2014 Feb;50(2):112-7. doi: 10.1111/jpc.12400. Epub 2013 Oct 18.
- Background Shah V, Taddio A, Rieder MJ; HELPinKIDS Team. Effectiveness and tolerability of pharmacologic and combined interventions for reducing injection pain during routine childhood immunizations: systematic review and meta-analyses. Clin Ther. 2009;31 Suppl 2:S104-51. doi: 10.1016/j.clinthera.2009.08.001.
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- Background Sparks L. Taking the "ouch" out of injections for children. Using distraction to decrease pain. MCN Am J Matern Child Nurs. 2001 Mar-Apr;26(2):72-8. doi: 10.1097/00005721-200103000-00005.
- Background Taddio A, Appleton M, Bortolussi R, Chambers C, Dubey V, Halperin S, Hanrahan A, Ipp M, Lockett D, MacDonald N, Midmer D, Mousmanis P, Palda V, Pielak K, Riddell RP, Rieder M, Scott J, Shah V. Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline (summary). CMAJ. 2010 Dec 14;182(18):1989-95. doi: 10.1503/cmaj.092048. Epub 2010 Nov 22. No abstract available.
- Background Taddio A, Chambers CT, Halperin SA, Ipp M, Lockett D, Rieder MJ, Shah V. Inadequate pain management during routine childhood immunizations: the nerve of it. Clin Ther. 2009;31 Suppl 2:S152-67. doi: 10.1016/j.clinthera.2009.07.022.
- Background Taddio A, Ilersich AL, Ipp M, Kikuta A, Shah V; HELPinKIDS Team. Physical interventions and injection techniques for reducing injection pain during routine childhood immunizations: systematic review of randomized controlled trials and quasi-randomized controlled trials. Clin Ther. 2009;31 Suppl 2:S48-76. doi: 10.1016/j.clinthera.2009.07.024.
- Background Woods JA, Keylock KT, Lowder T, Vieira VJ, Zelkovich W, Dumich S, Colantuano K, Lyons K, Leifheit K, Cook M, Chapman-Novakofski K, McAuley E. Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial. J Am Geriatr Soc. 2009 Dec;57(12):2183-91. doi: 10.1111/j.1532-5415.2009.02563.x.
- Background Yalcin SS, Gumus A, Yurdakok K. Prophylactic use of acetaminophen in children vaccinated with diphtheria-tetanus-pertussis. World J Pediatr. 2008 May;4(2):127-9. doi: 10.1007/s12519-008-0025-7.
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- Background Flucelvax US Package Insert. March 2014. Novartis Vaccines and Diagnostics, Inc.
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- Background Hayat, H., Khan, Parwez S. & Hayat, G. (2011). The effect of prophylactic paracetamol administration on adverse reactions following DTP vaccination. Eastern Journal of Medicine 16, 258-260.
- Background Schuler PB, Lloyd LK, Leblanc PA, Clapp TA, Abadie BR, Collins RK. The effect of physical activity and fitness on specific antibody production in college students. J Sports Med Phys Fitness. 1999 Sep;39(3):233-9.
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Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Ibuprofen | Small molecule | 800 mg | Oral |