What is the time frame for the TCV (Tetanus, Conjugated, Vaccine) vaccine to induce fever?

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Time Duration for TCV Vaccine to Induce Fever

Fever typically occurs within 24 to 72 hours after TCV (Typhoid Conjugate Vaccine) administration, with most cases appearing within the first 48 hours post-vaccination.

Timing of Fever Onset

Based on available evidence for typhoid conjugate vaccines:

  • Fever onset is most common within 48 hours of TCV administration, consistent with the typical post-vaccination fever pattern seen with other conjugated vaccines 1, 2
  • Peak incidence occurs within the first 24 hours, with approximately 7.4% of vaccine recipients reporting fever at 48-hour follow-up 2
  • By 7 days post-vaccination, fever incidence decreases to approximately 4% of recipients, suggesting most febrile reactions resolve within the first week 2

Fever Incidence Data

The largest safety evaluation of TCV (Typbar-TCV) in the public sector provides specific timing data:

  • At 48 hours post-vaccination: 416 of 5,605 caregivers (7.4%) reported fever 2
  • At 7 days post-vaccination: 200 of 4,728 caregivers (4%) reported fever 2
  • Overall adverse event rate: Only 0.2% of 113,420 vaccine recipients reported adverse events through passive surveillance, with fever being among the most common 2

Clinical Context and Management

Temperature thresholds requiring evaluation:

  • Fever ≥40.5°C (≥105°F) within 48 hours of any tetanus toxoid-containing vaccine (which includes TCV) mandates immediate medical assessment 1, 3
  • Any fever beginning ≥24 hours after vaccination should not be automatically attributed to the vaccine and requires evaluation to rule out serious bacterial infection 1

Important clinical distinctions:

  • TCV-related fever is typically self-limited and resolves without intervention within 48-72 hours 2
  • The fever pattern differs from DTaP vaccines, where fever >38°C occurs in 6.3-26.4% depending on dose number 3
  • No serious vaccine-attributable adverse events were identified in the large-scale TCV introduction study 2

Age-Specific Considerations

For infants and young children receiving TCV:

  • Children aged 6 months to 14 years were included in the safety evaluation, with fever rates consistent across age groups 2
  • Younger children (6 months to 2 years) may have faster antibody decay but similar acute fever patterns 4
  • Acetaminophen 10-15 mg/kg every 4-6 hours can be used for comfort if fever occurs, though routine prophylactic use is not recommended 1

Key Clinical Pitfalls to Avoid

  • Do not dismiss fever occurring >72 hours post-vaccination as vaccine-related; investigate for other infectious causes 1
  • Do not confuse typical post-vaccination fever with the rare serious reactions (hypotonic-hyporesponsive episodes, seizures, persistent crying ≥3 hours) that require immediate evaluation 1, 3
  • Monitor for 15 minutes post-vaccination to prevent fall-related injuries from vasovagal syncope, which can occur immediately after any injection 5

References

Guideline

Post-Vaccine Fever Management in Infants

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Evaluation of Vaccine Safety After the First Public Sector Introduction of Typhoid Conjugate Vaccine-Navi Mumbai, India, 2018.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Longevity of immune response after a single dose of typhoid conjugate vaccine against Salmonella Typhi among children in Hyderabad, Pakistan.

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2024

Guideline

Adverse Events Following Tetanus Toxoid-Containing Vaccines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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