Vaccination policies, practices, and procedures in level-III neonatal intensive care units across Canada: An...

Infant prematurity, low birth weight, and critical illness often require neonatal intensive care unit (NICU) admission. Although beneficial, hospitalization may interrupt the usual processes through which infants receive vaccines in the community. To mitigate potential disruptions to scheduled vaccinations, an infant's NICU stay may be an opportunity for timely vaccine delivery. The frequency and nature of these practices are known to vary across Canada. This study aimed to determine what vaccination policies, practices, and procedures exist in Canadian Level-III NICUs.

A pan-Canadian environmental scan was conducted from May to October 2023 to identify vaccine policies, practices, and procedures from Level-III NICUs. Data collection included an internet search and email consultation with NICU professionals (i.e., nurses, physicians, etc.). Information was synthesized to identify the commonalities and differences between vaccination practices across Canada.

Twenty-one (out of 32 contacted) Level-III NICUs responded, with all respondents (21/21) confirming that their NICU provided selected routine vaccinations and respiratory syncytial virus (RSV) prophylaxis to admitted infants. NICU nurses (21/21) were the main vaccine provider, with hospitals in one province augmenting delivery with public health nurses (3/21). Only 8/21 NICUs reported delivering rotavirus vaccines prior to discharge.

Across Canada, all surveyed Level-III NICUs reported delivering some routine vaccinations, indicating an effort to optimize vaccine uptake during hospitalization. There were variations in the specific vaccines (e.g. rotavirus vaccines) provided. Understanding where and why these variations exist is crucial for informing and enhancing evidence-informed NICU vaccination programs nationwide.