NeoNotes
Journal Club
Andrew
B. Kairalla MD, Editor
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Preterm (PT) infants are at increased risk of experiencing complications
of vaccine-preventable diseases but are less likely to receive
immunizations on time. Medically stable PT and low birth weight (LBW)
infants should receive full doses of diphtheria, tetanus, acellular
pertussis, Haemophilus influenzae type b, hepatitis B,
poliovirus, and pneumococcal conjugate vaccines at a chronologic age
consistent with the schedule recommended for full-term infants.
Infants with birth weight less than 2000 g may require modification
of the timing of hepatitis B immunoprophylaxis depending on maternal
hepatitis B surface antigen status. All PT and LBW infants benefit
from receiving influenza vaccine beginning at 6 months of age before
the beginning of and during the influenza season. All vaccines
routinely recommended during infancy are safe for use in PT and LBW
infants. The occurrence of mild vaccine-attributable adverse events
are similar in both full-term and PT vaccine recipients. Although the
immunogenicity of some childhood vaccines may be decreased in the
smallest PT infants, antibody concentrations achieved usually are
protective.
Comment. Bottom lines:
Ø Give routine vaccines at same doses and same chronologic age as for term babies;
Ø Add influenza vaccine at 6 and 7 months of age (in-season).
Ø Don’t forget Synagis during RSV season.
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