Apnoea and bradycardia in preterm infants following immunisation with pentavalent or hexavalent vaccines

Abstract

Although most infants tolerated immunisation well, the incidence of recurrent or increased apnoea or bradycardia in respiratory stable preterm infants following the first immunisation with penta- or hexavalent vaccines was 13%. Most apnoea or bradycardia events required intervention but did not have serious consequences. Monitoring of all preterm infants following immunisation in the neonatal intensive care unit is recommended.

Vaccination of Preterm Infants

“…Rates have been reported to range between 13 and 25% [7][8][9]. Resurgence or an increase of bradycardia and desaturation episodes or isolated desaturation episodes have been reported in 43% of infants immunized with a hexavalent vaccine [10].…”

Vaccination of Premature/Low-Birth-Weight Children

“…Thus, apnea with/without bradicardia developed in 20% out of 98 vaccinated children (GA -24-31 weeks, average age -80.6 days); it most often developed without desaturation and ceased spontaneously. 5 children of lesser GA, who were subject to APV longer than other children, required intervention (additional oxygen); in general, the authors indicate clinical insignificance of these episodes [23]. However, in 1999, American Academy of Pediatrics recommended a vaccine with acellular pertussis component -DtaP -to use in premature infants [24].…”

Adverse cardiorespiratory events following primary vaccination of very low birth weight infants

“…Estudos prévios da vacina de células inteiras contra coqueluche relataram sobre eventos cardiorrespiratórios (ou seja, recorrência de apneia, bradicardia ou dessaturações de SpO 2 ) em recém-nascidos pré-termo [2][3][4][5][6] . Em estudos publicados recentemente, foi usada uma vacina acelular contra coqueluche, mas também foram relatadas reações adversas semelhantes [7][8][9][10][11][12] . A taxa de reações adversas teve grande variação entre os estudos (6% a 50%) 2,[11][12][13][14][15][16][17] .…”

“…Em estudos publicados recentemente, foi usada uma vacina acelular contra coqueluche, mas também foram relatadas reações adversas semelhantes [7][8][9][10][11][12] . A taxa de reações adversas teve grande variação entre os estudos (6% a 50%) 2,[11][12][13][14][15][16][17] . Estudos sugerem que recém-nascidos de muito baixo peso (RNMBP, peso ao nascer < 1.500 g) são um grupo de pacientes particularmente vulnerável ao desenvolvimento de reações adversas graves 8,15,16 .…”