Sir.—Febrile and local reactions to diphtheria and tetanus toxoids and pertussis (DTP) vaccine are a frequent and major concern to parents and a source of discomfort to children. Among the most common reactions is fever, which occurs in 47% of immunized children.1 As a result, some pediatricians may empirically prescribe prophylactic antipyretic therapy at the time of vaccination. The extent of this practice has not been documented to our knowledge and, until recently, the benefit of such therapy has not been examined.
To assess the frequency of this practice, we conducted a survey of community-based pediatricians to determine whether, and under what circumstances, they recommended prophylactic antipyretic therapy for children receiving DTP vaccine. The survey was performed before recently published reports documented the effectiveness of prophylactic acetaminophen therapy with DTP immunization.2,3 Despite the lack of studies documenting the usefulness of antipyretics, we anticipated that our survey would