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Section 1. Active and Passive Immunization
Immunization in Special Clinical Circumstances
Preterm and Low Birth Weight Infants 18
Preterm infants born at less than 37 weeks’ gestation and infants of low birth weight (less than 2500 g) should, with few exceptions, receive all routinely recommended childhood vaccines at the same chronologic age as 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 several vaccines given to very low birth weight (less than 1500 g) and very early gestational age (less than 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 term infants should not be reduced or divided when given to preterm or low birth weight infants.
Preterm and low birth weight infants tolerate most childhood vaccines as well as term infants do. Apnea, reported to have occurred in some extremely low birth weight (less than 1000 g) infants after use of diphtheria and tetanus toxoids and whole-cell pertussis vaccine (DTP), 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 were reported to experience benign febrile seizures more frequently than were 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 and
Related text in Red Book:
- Reporting of Adverse Events
Red Book 2009: 42-51.[Extract] [Full Version] - Vaccine Administration
Red Book 2009: 17-20.[Extract] [Full Version] - Scheduling Immunizations
Red Book 2009: 21-31.[Extract] [Full Version] - Respiratory Syncytial Virus
Red Book 2009: 560-569.[Extract] [Full Version] - Hepatitis B
Red Book 2009: 337-356.[Extract] [Full Version] - Influenza
Red Book 2009: 400-412.[Extract] [Full Version] - Pertussis (Whooping Cough)
Red Book 2009: 504-519.[Extract] [Full Version]
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