Response of Preterm Newborns to Immunization With a Hexavalent Diphtheria–Tetanus–Acellular Pertussis–Hepatitis B Virus–Inactivated Polio andHaemophilus influenzaeType b Vaccine: First Experiences and Solutions to a Serious and Sensitive Issue

Abstract

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.

Very low birth weight infants have only few adverse events after timely immunization

“…10 Another concern with the first immunization at 2 months, regardless of their corrected age, is an inadequate antibody response after the vaccination. Different groups [11][12][13][14] analyzed the antibody response in premature babies and found over a longitudinal time lower antibody titres, but in most of them the antibody levels were in the protective range. Local reactions were rare, and training on the correct immunization technique is considered indispensable.…”

Vaccination of Premature/Low-Birth-Weight Children

“…A vaccine conjugated with tetanus toxoid (TT) causes lower antibody levels and seroconversion rate in children with GA <32 weeks observed until the age of 5 than in premature infants even after 3 administrations (at 3, 4 and 5 months of age). However, the authors emphasize that the vaccination has protective effect for this group, too [37]. It appears that the shortened primary immunization does not produce sufficient results in small premature infants, while almost all children, including premature infants with GA ≤29 weeks, developed protective antibody levels after 3 administrations of a CRM 197 -conjugate vaccine with at 2, 4 and 6 months of age [33].…”

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]. Apneas, bradycardias and desaturations have been observed to occur more often in preterm infants with a chronological age below 67 to 70 days at the time of first immunization [11,12].…”