I would double/triple as you normally would with that fever (my ped endo says triple). If the fever drops right away, then you will probably only need the single stress dose.

It was when Olivia had her 4-year vaccines in November that she spiked a fever (started at 100 and ended up at 103.5 4 hours later), vomitted, I gave her an injected and we still ended up very lethargic and in the ER for fluids.

Best regards,

Janet