Comfort measures, such as distraction (e.g. playing music or pretending to blow away the pain), ingestion of sweet liquids, breastfeeding, cooling of the injection site, and topical or oral analgesia, can help infants or children cope with the discomfort associated with vaccination. Pretreatment (30–60 minutes before injection) with 5% topical lidocaine-prilocaine emulsion can decrease the pain of vaccination by causing superficial anesthesia. Topical lidocaine-prilocaine emulsion should not be used on infants aged <12 months who are receiving treatment with methemoglobin-inducing agents because of the possible development of methemoglobinemia.Use of a topical refrigerant (vapocoolant) spray immediately before vaccination can reduce the short-term pain associated with injections and can be as effective as lidocaine prilocaine cream. Acetaminophen may be used immediately following DTP vaccination at the rate of 15 mg/kg/dose to reduce the discomfort and fever.

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