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Hexavalent Vaccine
Omeñaca F, Garcia-Sicilia J, García-Corbeira P, et al. Response of Preterm Newborns to Immunization With a Hexavalent Diphtheria–Tetanus–Acellular Pertussis–Hepatitis B Virus–Inactivated Polio and Haemophilus influenzae Type b Vaccine: First Experiences and Solutions to a Serious and Sensitive Issue. Pediatrics (Dec 2005);116:1292-98. [Full Text]
Objective. Preterm infants are at increased risk from infections and should be vaccinated at the usual chronological age. The aim of the study was to evaluate the immunogenicity and reactogenicity of a hexavalent diphtheria–tetanus–acellular pertussis–hepatitis B virus–inactivated polio and Haemophilus influenzae type b (DTPa-HBV-IPV/Hib) vaccine in preterm infants.
Methods. In a comparative trial, 94 preterm infants between
24 and 36 weeks (mean ± SD gestational age: 31.05 ± 3.45 weeks;
mean birth weight: 1420 ± 600 g) and a control group of 92 full-term
infants were enrolled to receive 3 doses of a DTPa-HBV-IPV/Hib
vaccine at 2, 4, and 6 months. Immunogenicity was assessed in serum
samples that were taken before and 4 weeks after primary vaccination.
Evaluation of reactogenicity was based on diary cards.
Results. All preterm (n = 93) and full-term (n = 89)
infants who were included in the immunogenicity analysis had
seroprotective titers to diphtheria; tetanus; and polio virus types
1, 2, and 3. The immune response to the Hib and hepatitis B
components was lower in preterm than in full-term infants: 92.5%
versus 97.8% and 93.4% versus 95.2%, respectively. Vaccine response
rates for pertussis antigens were >98.9% in both study groups.
Although most geometric mean titers were lower in preterm infants,
titers were similar for pertussis, a major threat for premature
infants. The vaccine was well tolerated, and there were no differences
in reactogenicity between groups. Some extremely immature infants
experienced transient cardiorespiratory events within the 72
hours after the first vaccination with no clinical repercussion.
Conclusions. Preterm infants who were immunized with the
hexavalent DTPa-HBV-IPV/Hib vaccine at 2, 4, and 6 months displayed
good immune response to all antigens. The availability of this
vaccine greatly facilitates the vaccination of premature infants.
Comments. At last, we have a way to avoid giving our preemies so many IM injections when they reach 2 months of age. Maybe one day we will have an “omnivax” that has everything in it. This is a good start. ABK.
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