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Timing of vaccinations in premature infants

C T Dangio1, C B Hall

  • 1Department of Paediatrics, University of Rochester School of Medicine and Dentistry, Strong Children's Research Center, Rochester, New York 14642, USA. carl_dangio@urmc.rochester.edu

Biodrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
|November 24, 2007
PubMed

Insights

Premature infants, especially those born very early, show varied vaccine responses due to immune system immaturity. Optimal infant vaccination requires careful consideration of specific preterm infant needs and exceptions to general guidelines.

Area of Science:

  • Immunology
  • Neonatal Medicine
  • Vaccinology

Background:

  • Preterm infants possess immunological immaturities that can affect vaccine efficacy.
  • While larger premature infants often exhibit responses similar to full-term infants, very premature infants (<30 weeks' gestation) demonstrate specific defects in vaccine responsiveness.

Purpose of the Study:

  • To review the immunogenicity and tolerability of various vaccines in preterm infants.
  • To highlight specific challenges and exceptions in vaccinating preterm infants compared to term infants.

Main Methods:

  • Review of existing literature on vaccine responses in preterm infants.
  • Analysis of immunogenicity data for diphtheria, tetanus, pertussis, poliovirus, Haemophilus influenzae type b, and hepatitis B vaccines.
  • Consideration of factors influencing vaccine response, including gestational age, birth weight, and infant health status.

Main Results:

  • Diphtheria, tetanus, and pertussis vaccine immunogenicity is generally comparable between full-term and preterm infants.
  • Poliovirus vaccines may not consistently elicit adequate antibody responses in preterm infants.
  • Hepatitis B vaccine given at birth shows reduced immunogenicity in infants <1750g, improved by delayed administration.
  • Haemophilus influenzae type b conjugate vaccine immunogenicity varies, influenced by conjugate protein and infant health.
  • Sick preterm infants may experience increased apnea episodes post-vaccination.

Conclusions:

  • Vaccination recommendations for term infants are generally applicable to preterm infants, but specific exceptions exist.
  • Very premature infants (<30 weeks' gestation) require special attention regarding vaccine responsiveness.
  • Further research is needed on the persistence of immunity, immune response quality, and new vaccine tolerability/immunogenicity in preterm infants.

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