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The following protocol is given to the parents of MSUD patients who are followed at Children's Hospital of Philadelphia, Philadelphia, PA, U.S.A., as a guide to use when their children are receiving immunizations of any kind (including flu shots), and is printed here with permission. This is presented on this site for educational and informational purposes only, and as a point of discussion with your child's own physician. Please follow the advice of your child's doctor.

This protocol was designed to help prevent or diminish any possible metabolic complications that could arise from giving the vaccines. It should NOT discourage parents from making sure that their child receives all necessary immunizations. It must be borne in mind that the risk to an MSUD child of having metabolic complications after contracting the flu or any of the common childhood diseases is much greater than that of developing metabolic complications from the immunization itself.

Protocol for MSUD Children Receiving Immunizations and/or Flu shots:

  1. Initiate the sick day diet on the day of giving of the vaccine
  2. Do not give vaccine if child is febrile, has ketonuria or seems in any way ill
  3. Continue the sick day diet for 24 hours after giving the vaccine
  4. Contact physician if child manifests lethargy, vomiting, obtundation, ketonuria or strong odor of maple syrup urine disease
  5. Can give Tylenol**, as recommended by physician, for fever or discomfort.
  6. Resume regular diet 24 hous after giving vaccine, assuming no complications


** Note that the recommended medication in the above article is Tylenol (Acetominiophen).  This recommendation is consistent with information reported in the May 2002 edition of the MSUD Family Support Group Newsletter which reads: "Do not give aspirin or over-the-counter medications containing aspirin to children with MSUD. Children with MSUD are very susceptible to a Reyes Syndrome-like illness with the accompanying brain edema. It is very important that children with MSUD do not take aspirin or products containing aspirin. Make it a practice to read the ingredient list on all over-the-counter medications."

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