Effect of neonatal circumcision on pain responses during vaccination in boys

Using data from one of our randomised trials, we investigated post-hoc whether male neonatal circumcision is associated with a greater pain response to routine vaccination at 4 or 6 months. Pain response during routine vaccination with diphtheria-pertussis-tetanus (DPT) alone or DPT followed by Haemophilus influenzae type b conjugate (HIB) was scored blind. 42 boys received DPT and 18 also received HIB. After DPT, median visual analogue scores by an observer were higher in the circumcised group (40 vs 26 mm, P=0·03) After HIB, circumcised infants had higher behavioural pain scores (8 vs 6, P=0·01) and cried longer (53 vs 19 s, P=0·02). Thus neonatal circumcision may affect pain response several months after the event.