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Uptake of immunisations in low birthweight infants
Insights
Preterm infants experienced initial delays in receiving immunisations, particularly those weighing under 2000g. However, vaccination coverage became similar across groups by 18 months, though overall uptake remained poor.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- The recommended timing for infant immunisations, especially for preterm infants, is a subject of ongoing debate.
- A specific guideline suggests initiating immunisations three months post-birth.
Purpose of the Study:
- To assess the implementation of immunisation timing recommendations for preterm infants.
- To identify potential delays in vaccination schedules based on birth weight and gestational age.
Main Methods:
- Retrospective study of infant immunisation records in a specific London borough for births in 1984.
- Infants categorized by birth weight (<2000g vs. heavier) and gestational age (≤37 weeks vs. full-term).
- Analysis of cumulative vaccination uptake for triple immunisations and pertussis components over time.
Main Results:
- Infants weighing less than 2000g showed a significant initial delay in receiving the first course of immunisations compared to heavier infants.
- By 18 months, catch-up vaccination resulted in nearly identical coverage for the first course across birth weight groups.
- Delays were also observed in preterm infants (≤37 weeks gestation), though gestational age data was incomplete.
- Overall immunisation uptake was suboptimal across all infant groups.
- Differences in consent rates did not significantly impact the findings.
Conclusions:
- Initial delays in immunisation for low birth weight and preterm infants are evident.
- While catch-up vaccination improves coverage, overall uptake needs enhancement.
- Dissemination of findings prompted interest in improving immunisation practices and adherence to recommendations.
Abstract:
The timing of immunisations for preterm infants is controversial. Because of the statement by the British Paediatric Association/Joint Committee on Vaccination and Immunisation Liaison group that immunisations should normally begin three months after the date of birth, the records of all infants born in 1984 and currently (June 1986) resident in the London Borough of Newham were studied to find out if this recommendation was being implemented. Subjects were divided into groups by birth weight and where possible by gestational age. Cumulative uptakes by age of any component of the first and third triple immunisations, and of the pertussis component, were plotted separately. Comparison of uptake of the first course showed a considerable initial delay for infants weighing less than 2000 g at birth compared with heavier babies, but by 18 months the coverage was almost identical. This difference was not evident for the third course. A similar delay was apparent when infants of 37 weeks' gestation or less were compared with babies born at full term, though recording of gestational age was incomplete. Final overall uptake was poor for all groups. Differences among groups in numbers consenting were not an important factor. Informing those responsible for giving the immunisations of these findings has stimulated their interest in improving practice by implementing the recommendations.