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Archives of Disease in Childhood 2006;91:929-935; doi:10.1136/adc.2005.086306
Copyright © 2006 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

REVIEW

Immunisation of premature infants

J Bonhoeffer1, C-A Siegrist2, P T Heath1

1 St George’s Hospital, London, UK
2 University of Geneva, Geneva, Switzerland

Correspondence to:
Correspondence to:
Dr Paul T Heath
Division of Child Health, St George’s, University of London Cranmer Terrace, London SW17 0RE, UK; pheath{at}sgul.ac.uk

ABSTRACT

Premature infants are at increased risk of vaccine preventable infections, but audits have shown that their vaccinations are often delayed. Early protection is desirable. While the evidence base for immunisation of preterm infants is limited, the available data support early immunisation without correction for gestational age. For a number of antigens the antibody response to initial doses may be lower than that of term infants, but protective concentrations are often achieved and memory successfully induced. A 2-3-4 month schedule may be preferable for immunisation of preterm infants in order to achieve protection as early as possible, but an additional dose may be required to achieve persistence of protection. This update focuses on the use of routine childhood vaccines in premature infants.

Abbreviations: AEFI, adverse events following immunisation; DTaP, diphtheria-tetanus-acellular pertussis vaccine; DTwP, diphteria-tetanus-whole cell pertussis vaccine; GMC, geometric mean concentration; GMT, geometric mean titre; Hep B, hepatitis B; Hib, Haemophilus influenzae type b; IPV, inactivated polio vaccine; MenC, meningococcal group C conjugate; MMR, measles-mumps-rubella; PCV, pneumococcal conjugate vaccine; PPD, purified protein derivative

Keywords: immunisation; prematurity; review; vaccine


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