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Vaccines and preterm neonates: why, when, and with what

Susanna Esposito1, Domenico Serra, Laura Gualtieri

  • 1Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy. Susanna.esposito@unimi.it

Early Human Development
|September 25, 2009
PubMed

Insights

Preterm (PTIs) and low birth weight infants (LBWIs) mount effective immune responses to routine vaccines. Early vaccination using standard schedules, with a modified hepatitis B vaccine approach for very low birth weight infants, ensures protection against infectious diseases.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Neonatology

Background:

  • Preterm infants (PTIs) and low birth weight infants (LBWIs) are highly susceptible to infectious diseases.
  • Their immune responses to standard vaccinations require careful evaluation.

Purpose of the Study:

  • To review the immune response, protection, safety, and tolerability of vaccines in PTIs and LBWIs.
  • To establish optimal vaccination schedules for these vulnerable populations.

Main Methods:

  • Systematic review of existing literature on vaccine immunogenicity, safety, and efficacy in PTIs and LBWIs.
  • Analysis of comparative studies between PTIs/LBWIs and full-term infants (FTIs).

Main Results:

  • Vaccines are generally immunogenic, safe, and well-tolerated in PTIs and LBWIs.
  • Standard vaccination schedules are recommended, except for the hepatitis B vaccine in infants <2000g at birth, which may require a repeated dose.
  • Early active immunization is crucial for protecting these high-risk infants.

Conclusions:

  • PTIs and LBWIs benefit from early vaccination following established schedules.
  • Adjustments for specific vaccines, like hepatitis B, are necessary for optimal protection in very low birth weight infants.
  • Convincing healthcare providers and parents of the safety and importance of these recommendations is essential.

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