Monitoring Preemies after DtaP

Flatz-Jequier A, Posfay-Barbe KM, Pfister RE, et al. Recurrence of Cardiorespiratory Events following Repeat DTaP-Based Combined Immunization in Very Low Birth Weight Premature Infants. J Pediatr (Sept 2008); 153: 429-31. Full Text | PDF (111 KB)

Summary: We evaluated the tolerance to immunization of 64 very low birth weight preterm infants. Thirty-three of the infants experienced a cardiorespiratory event after the first vaccination, and 6 of these 33 (18%) had a recurrence after the second vaccination, including 2 infants previously discharged to home. A cardiorespiratory event associated with the first vaccination was the sole risk factor for recurrence identified.

Comments: The authors of this paper observed that 18% of premature babies who had cardiorespiratory events after their first DTaP vaccine, had similar events after the second dose of that vaccine 1-2 months later. They recommend that when preemies “react” to the first DTaP dose and are discharged before the 2^nd dose, consideration be given to re-admission and monitoring for 24-48 hours at the time of the second dose. This seems a bit extreme to me. For more on ALTE events after immunizations in preterm babies, see http://fsneo.org/JourClub/8-032.htm. ABK.

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