• immunisation
• general paediatrics

We read with interest recently published articles regarding fever post-immunisation following the introduction of the four-component meningococcal B vaccine (4CMenB).1–3

In retrospective1 and prospective2 audits, Nainani et al (n=38) and Kapur et al (n=35) demonstrated significant increases in emergency department (ED) attendances (0.8% of the local vaccinated population2), investigations (venepuncture in 38%1 and 62%,2 lumbar puncture (LP) in 22%1 and 17%2) and hospitalisations (72%1 and 51%2 (for post-immunisation fever). Murdoch et al’s3 self-controlled case series estimated an additional 1440 hospital admissions per year in the UK following 4CMenB introduction.

We conducted a retrospective audit of infants presented to the ED at …