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Appendices

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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 full-term infants. Gestational age and birth weight are not limiting factors when deciding whether a clinically stable preterm 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) and very early gestational age (<29 weeks) neonates, most preterm infants, including infants who receive dexamethasone for chronic lung disease, produce sufficient vaccine-induced immunity to prevent disease. Vaccine dosages 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 (<1000 g) infants of fewer than 31 weeks’ gestation after use of diphtheria and tetanus toxoids and whole-cell pertussis (DTP) 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 DTP and Haemophilus influenzae type b (Hib) vaccine also were reported to experience benign febrile seizures more frequently than were full-term infants given the same vaccines. Cardiorespiratory events, including apnea and bradycardia with oxygen desaturation, frequently increase in very low birth weight infants given combination diphtheria and tetanus toxoids . . . [Go to Full Text]


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Reporting of Adverse Events

Red Book 2006: 41-50. [Extract] [Full Version]  

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Respiratory Syncytial Virus

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