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The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
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Microorganisms play a fundamental role in vaccine development, gene therapy, and therapeutic production. Their biological properties are harnessed to advance medicine and public health. Beyond immunization, microorganisms contribute to gut health, antibiotic synthesis, and genetic disease treatment.Live Attenuated and Inactivated VaccinesLive attenuated vaccines, such as the measles, mumps, and rubella (MMR) vaccine, utilize weakened forms of pathogens to closely resemble natural infections.
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Vaccinations in preterm infants: Which and when?

Charline Schmitt1, Sybelle Goedicke-Fritz1, Ingmar Fortmann2

  • 1Department of General Pediatrics and Neonatology, Saarland University Medical Center, 66421, Homburg, Germany; Center for Genderspecific Biology and Medicine (CGBM), Saarland University Medical Center, 66421, Homburg, Germany.

Seminars in Fetal & Neonatal Medicine
|October 16, 2025
PubMed
Summary

Preterm infants face higher infection risks due to immature immunity. This review examines vaccine safety, efficacy, and timing for preterm infants, highlighting strategies to improve immunization rates and protect this vulnerable population.

Keywords:
ImmunizationMicrobiomePreterm infantsSafetyVaccination

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Area of Science:

  • Pediatrics
  • Immunology
  • Public Health

Background:

  • Preterm infants (10% of global births) have immature immune systems, increasing infection susceptibility.
  • Reduced maternal antibody transfer further compromises their defense against pathogens.
  • Current immunization guidelines based on chronological age are often not met in preterm infants, leading to delayed or incomplete vaccination.

Purpose of the Study:

  • To review current evidence on vaccine safety, efficacy, and optimal timing for preterm infants.
  • To emphasize primary immunizations and vaccines during the first year of life.
  • To explore novel strategies for enhancing vaccine responsiveness in this population.

Main Methods:

  • Comprehensive literature review of studies on preterm infant immunization.
  • Analysis of immunological characteristics affecting vaccine response.
  • Evaluation of emerging vaccine technologies and approaches.

Main Results:

  • Preterm infants exhibit distinct immunological traits, including impaired T- and B-cell responses and altered microbiome development, leading to reduced vaccine responsiveness.
  • Evidence on vaccine safety and efficacy in preterm infants is summarized, with a focus on primary immunization schedules.
  • Emerging approaches show promise for improving vaccine efficacy.

Conclusions:

  • Timely and complete immunization is critical for reducing preventable infections in preterm infants.
  • Novel strategies like mRNA vaccines, adjuvants, maternal immunization, and microbiome modulation offer potential to enhance vaccine efficacy.
  • Adherence to vaccination recommendations is essential for the health of this vulnerable group.