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[Vaccination rate of premature infants at 6 and 24 months of age: a pilot study]
D Pinquier1, C Adde-Michela, D Ploin
1EA4309, Service de Pédiatrie Néonatale et Réanimation, Université de Rouen, CHU Charles-Nicolle, Institut Hospitalo-Universitaire de Recherche Biomédicale, 1 Rue Germont, 76031 Rouen Cedex, France. didier.pinquier@chu-rouen.fr
Insights
Vaccine coverage for premature infants born before 33 weeks gestation is often delayed and incomplete, increasing their risk for preventable diseases. Early, in-hospital vaccination initiation is recommended for these vulnerable infants.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Context:
- Premature infants born before 33 weeks gestation (VLBW infants) have unique health needs.
- Vaccine practices for this population are not well-documented.
- Adherence to the recommended immunization schedule is crucial for preventing infectious diseases.
Purpose:
- To examine vaccine coverage in premature infants aged 0–24 months.
- To assess adherence to the French national immunization schedule.
- To identify gaps in vaccination practices for this high-risk group.
Summary:
- A prospective study of 87 premature infants revealed delayed vaccine initiation and suboptimal coverage for DTPCoqHib, hepatitis B, and MMR vaccines by 2 years of age.
- While BCG coverage was high, hepatitis B vaccination remained incomplete in a significant proportion of infants.
- Vaccination practices did not align with chronological age, leaving infants susceptible to pertussis during the first six months.
Impact:
- Delayed vaccination increases the window of susceptibility to serious infections like pertussis in premature infants.
- Current vaccination practices necessitate adjustments to ensure timely and complete immunization.
- In-hospital vaccination programs and caregiver vaccination are proposed strategies to improve infant immunization rates.
Unlabelled:
There are few data examining the vaccine practices for 0- to 24-month-old premature infants born before 33 GW. The aim of the study was to examine the vaccine coverage in this population according to the French schedule at 6 and 24 months.
Results:
Eighty-seven infants were included in this regional prospective study. The immunization program began late and was initialized principally with DTPCoqHib (63%), usually after the 4th month. Fewer than one infant out of two (45%) had received three doses by 6 months of age. At 2 years of age, the coverage was 99% at 3 doses and decreased to 83% for 4 doses. For the MMR vaccine, the average age of administration was after 15 months, and 95% of infants had received one dose of MMR at 2 years of age. BCG coverage at 2 years of age was 94%, administered on average at 7 months. Forty-seven percent of the infants had received at least one dose of hepatitis B vaccine before 2 years of age, but only 31% had received two doses and a booster at 2 years of age. The adaptation of vaccination practices basically concerns the initial date of vaccination, but the immunization calendar is not recovered at 2 years of age. This should be taken into account for pertussis disease prevention in these young infants during the first 6 months of life, increasing the susceptibility period for this infectious disease.
Discussion And Conclusion:
The vaccine practices do not follow the postnatal chronological age of the premature baby according to the schedule recommended for full-term infants and vaccination is begun late. Based on the CSHPF vaccination recommendations, nearly 7 premature infants out of 10 have an incomplete immunization status for DTPCoqHib, hepatitis B, and ROR at 2 years of age. According to the pertussis coverage observed in premature infants, the new recommendations on vaccination of the newborn's care giver and family should be completed before the infant's discharge from the hospital using a new acellular vaccine for adult immunization. The initiation of an immunization program during hospitalization would be beneficial for premature babies still hospitalized after 2 months of age.
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