Fever is the most frequently reported adverse effect in children and adolescents. Fever associated with vaccination is defined as a temperature of greater than or equal to 38°C (100.4°F) measured at any site using a validated device. Fever is caused by a complex reaction induced by the production of cytokines that affect the hypothalamic neurons. This results in raising the hypothalamic set point. Temperature elevations above 40°C (104°F) can result in cellular and multi-organ dysfunction. Excessive temperature elevations rarely result from fever alone, but are usually coupled with other

thermoregulatory dysfunction.

The whole cell pertussis vaccine has been highly associated with temperature elevations; however, the prevalence has significantly decreased since the introduction of the acellular pertussis vaccine. Live virus vaccines are also associated with fever.

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