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C reactive protein response after routine vaccination among rural Zimbabwean infants
  1. Jonathan Broad1,2,
  2. James Church3,
  3. Kuda Mutasa3,
  4. Florence D Majo3,
  5. Naume V Tavengwa3,
  6. Bernard Chasekwa3,
  7. Jean H Humphrey3,4,
  8. Robert Ntozini3,
  9. Andrew J Prendergast3,5
  1. 1 Paediatric Infectious Disease, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
  2. 2 Genomics and Child health, Blizard Institute of Cell and Molecular Science, London, UK
  3. 3 Research Team, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
  4. 4 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5 Queen Mary University of London, London, UK
  1. Correspondence to Dr Jonathan Broad, Paediatric infectious disease, Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; jonathan.broad{at}

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Infants commonly develop fever after vaccination, meaning distinguishing illness from postvaccine symptoms is challenging. C reactive-protein (CRP) is often measured in febrile infants for consideration of antibiotics to treat a bacterial infection1; however, a rise in CRP post vaccination was reported in healthy children in Canada and Korea.2 ,3 The median CRP after meningococcal B vaccination was 12 mg/L in UK children (peak 160 mg/L).4

We evaluated postvaccination CRP in infants enrolled in the Sanitation, Hygiene, Infant Nutrition Efficacy (SHINE) trial in Zimbabwe.5 At 6 weeks, infants received oral polio and rotavirus, injectable pneumococcal and pentavalent vaccines (diphtheria, tetanus, pertussis, Haemophilus influenzae B and hepatitis B). Infants had blood collected between 1 month and 3 months and were eligible if CRP was measured within 14 days of vaccination. A CRP rise usually peaks 3–5 days following infection; therefore, increases were expected within the first week since these include inactivated and …

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  • JB and JC contributed equally.

  • Contributors JB and JC designed the study, conducted the analysis and wrote the main manuscript. KM, FDM and NVT codesigned the study, helped with the analysis and coauthored the manuscript. BC and RN reran the analysis and coauthored the manuscript. BC, JHH and AJP provided overall leadership, supported the design and analysis and write-up.

  • Funding This study was funded by Wellcome (108065/Z/15/Z).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.