high fever and high white blood cell count after prevnar vaccine

[kbreesea]

I just spent the last 4 hours in our Ped's office with my son who is 4 months old. Yesterday he went in for his 4 month check up and got the prevnar vaccine. Everything was fine until this morning when he woke up with a 103.5 fever. I took him in today, his temp was still in the 102-101 range and his white blood cell count came back abnormally high. Urine culture came back negative and we are waiting on his blood culture results (which I hope are negative as well or else we have to be admitted to the hospital). If the blood culture comes back negative, they will want to put him on antibiotics for 10 days. I'd rather not have him on the antibiotics just for the heck of it. I know that a high fever can be a reaction to the vaccine, but does anyone know if a high white blood cell count can also be a reaction? Thanks so much!

[Marnica]

Vaccines challenge/lower the immune system. It could be that the vaccine lowered your LO's immune system enableing some other sort of bacteria/virus to take hold.
High White blood cell counts are usually indicative of infection of some kind. However injecting all that stuff (7 "dead" bacterial strains and a host of chemicals) into a baby I would think could also elevate WBC as your baby is fighting off the pathogems that have been injected. Given the immediate timing (shot 1 day, next day fever and elevated WBC) it seems more likely as a result of vaccination. If it was that the baby had a virus or infection from the vaccine "challenging" the immune system, I would think there would still be an incubation period before symptoms set in. I think it's good you are getting it evaluated, but I would be leary of their advice. They will deny that this is a vaccine reaction. Whether you decide to give abx is up to you. If your baby picked up a virus (which is the most likely explanation) anb won't help anyway. They would only help if your baby has a bacterial infection. I would ask for proof that of that (a culture of some kind) before I gave abx. JMHO. Whatever you decide I hope your LO gets better soon!

[bookwormommy]

White blood cell counts can be elevated from other causes besides infection, including inflammation, physiologic stress, vasculitis, and drug reactions. eMedicine has a good overview: http://emedicine.medscape.com/article/956278-overview

If the link doesn't work, just search under leukocytosis.

And as PP pointed out, viral infections will also increase WBC, but antibiotics won't treat viruses.

So a doctor couldn't definitively say it was a bacterial infection based solely on an elevated total WBC (unless there were some specific changes with some of the different types of white blood cells), but they might feel they need to prescribe antibiotics just in case it is - you could have a bacterial infection somewhere in your body that wouldn't necessarily be detected on blood/urine cultures. They might feel they'd be liable if they didn't prescribe them. Could you ask them if they think a bacterial infection is likely or if this is a "just-in-case" scenario? I also would expect the fever to continue if there is a bacterial infection.

I wish you and your little one well!

[kbreesea]

Thank you!

[hollytheteacher]

i just wanted to add my 2 cents that we did one prevnar vax with our son and he got a very high fever the next day that lasted for 3 days and he was very lathargic and we decided we were not going to do any more prevnar after that.

He has not had any reaction/fever at all to dtap (he's had 3) or hib (he's had 2) and they were all VERY spaced out.

[Deborah]

http://www.wyeth.com/content/showlabeling.asp?id=134

see page 18 of the package insert

fever occurred more often following Prevnar than it did with the vaccine it was compared to.

I don't have time to read the entire insert, but there may be some other relevant info in there.

I'm sorry your baby is sick!

[majormajor]

how is your LO today? did you decide on the antibiotics?

the high WBC count is hallmark for an infection. unfortunately, you can't know whether it's viral or bacterial, unless of course they manage to culture the bacteria. if i were in your shoes, i'd see how his condition was progressing while you were waiting for the test results. had you given tylenol or did it go down on its own? is he happy and alert? drinking milk?

when my DD was 12 days old, she got very sick--limp, not nursing, and then a fever, and it happened VERY quickly. she did 3 days of IV antibiotics in the hospital, but her cultures didn't grow anything that they tested for, so we don't know whether it was a virus or a bacteria. it was her other symptoms even more than the fever (which was high for that age, 102) that scared everyone.

so, i dunno. if he appears to be on the mend on his own (fever down without drugs, happy, alert, nursing and wetting diapers), i'd ask how they felt about waiting 12 hours and reassessing. 4 mos is still really little though, so if they feel like he could still go downhill fast if it is indeed bacterial, i'd just go w/ the antibiotics. supplement you both w/ probiotics while you do them. and come back and let us know how he's doing.