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A 27-week gestation infant is approaching 2 months of age in a resource-poor hospital with no continuous monitoring or facilities for intubation. WHO guidance advocates vaccinating at 2 months, but you wonder about the possible risks of apnoea and bradycardia.
Structured clinical question
In hospitalised premature infants (population) what is the incidence of apnoea, bradycardia and need for respiratory support (outcome) following routine vaccination (intervention).
A PubMED search for ((‘Infant, Premature’ [Mesh] OR prematur* OR preterm) AND (‘Immunization’ [Mesh] OR ‘Vaccination’ [Mesh] OR Immunisation OR Immunization OR vaccination)) AND (‘Apnea’ [Mesh] OR apnoea OR apnea OR ‘Drug-Related Side Effects and Adverse Reactions’ [Mesh] OR adverse) found 312 articles (13 January 2016). A similar search of EMBASE found 428 articles.
Thirty-four articles provided primary evidence related to adverse events following vaccination in preterm infants, with two obtained through hand-searching references of included studies. Four considered non-routine vaccinations or components, 13 were retrospective and two case series. Of the …
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