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Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes
Marie-Theres Dammann1, Hannah Kraft1, Guido Stichtenoth1
1Department of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, Germany.
Vaccines
|January 24, 2025
Summary
Influenza immunization did not improve lung function or neurodevelopment in very-low-birth-weight infants (VLBWIs). Most VLBWIs remain unimmunized, highlighting the need for specific influenza vaccination guidelines for this high-risk group.
Area of Science:
- Neonatalogy
- Pediatric Pulmonology
- Pediatric Neurology
Background:
- Very-low-birth-weight infants (VLBWIs) face increased risks of severe influenza complications, including pneumonia, encephalitis, and death.
- Limited data exist on the effectiveness and outcomes of influenza immunization in VLBWIs.
Purpose of the Study:
- To provide epidemiological data on influenza immunization rates in German VLBWIs.
- To investigate the hypothesis that influenza immunization protects VLBWIs from neurodevelopmental impairment and preserves lung function at school age.
Main Methods:
- An observational, population-based study of VLBWIs born between 2009 and 2015 within the German Neonatal Network (GNN).
- A 6-year follow-up included lung function and neurodevelopmental testing.
- Uni- and multivariate analyses compared outcomes between immunized and non-immunized VLBWIs.
Main Results:
- 26% (871/3358) of VLBWIs received influenza immunization by age 6.
- Immunized infants had lower gestational age and higher rates of bronchopulmonary dysplasia (BPD).
- Early immunization showed no safety concerns and reduced bronchitis risk (OR: 0.2; 95% CI: 0.1-0.6), but 88% were unimmunized in their first season.
Conclusions:
- Influenza immunization was not linked to improved lung function (FEV1, FVC) or neurocognitive outcomes (IQ, SDQ) at school age.
- In Germany, only 25% of 6-year-old VLBWIs were immunized, with higher rates in preterm infants (<28 weeks) and those with BPD.
- Evidence-based influenza immunization guidelines are crucial for this vulnerable population.
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