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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 1. Active and Passive Immunization
IMMUNIZATION IN SPECIAL CLINICAL CIRCUMSTANCES
Preterm and Low Birth Weight Infants 1
Preterm infants less than 37 weeks’ gestation and infants of low birth weight (<2500 g) should, with few exceptions, receive all routinely recommended childhood vaccines at the same chronologic age as should full-term infants. Gestational age and birth weight are not limiting factors when deciding whether a clinically stable premature infant is to be immunized on schedule. Although studies have shown decreased immune responses to some vaccines given to very low birth weight (<1500 g), extremely low birth weight (<1000 g), and very early gestational age (<29 weeks) neonates, most preterm infants produce sufficient vaccine-induced immunity to prevent disease. Vaccine dosages normally given to full-term infants should not be reduced or divided when given to preterm and low birth weight infants.
Preterm and low birth weight infants tolerate most childhood vaccines as well as full-term infants. Apnea, reported to have occurred in some extremely low birth weight infants of fewer than 31 weeks’ gestation after use of diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) vaccine, has not been reported after use of acellular pertussis-containing vaccines in small numbers of extremely low birth weight infants. However, preterm infants given heptavalent pneumococcal conjugate vaccine (PCV7) concomitantly with DTwP and Haemophilus influenzae type b
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