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Am J Perinatol 2018; 35(14): 1394-1398
DOI: 10.1055/s-0038-1660453
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Variability in Immunization Practices for Preterm Infants

Srirupa Hari Gopal
1   Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
,
Kathryn M. Edwards
2   Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
,
Buddy Creech
2   Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
,
Joern-Hendrik Weitkamp
1   Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
› Author Affiliations Funding This work was supported by UL1 TR000445 from NCATS/NIH.
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Publication History

10 February 2018

30 April 2018

Publication Date:
08 June 2018 (online)

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Abstract

Introduction The Advisory Committee on Immunization Practices and the American Academy of Pediatrics (AAP) recommend the same immunization schedule for preterm and term infants. However, significant delays in vaccination of premature infants have been reported.

Objective The objective of this study was to assess the variability of immunization practices in preterm infants.

Study Design We conducted an online survey of 2,443 neonatologists in the United States, who are members of the Section for Neonatal-Perinatal Medicine of the AAP. Questions were targeted at immunization practices in the neonatal intensive care unit (NICU).

Results Of the 420 responses (17%) received, 55% of providers administer the first vaccine at >2-month chronological age. Most providers (83%) surveyed reported delaying vaccines in the setting of clinical illness. Sixty percent reported increasing frequency of apnea–bradycardia events following immunization. More than half administer the initial vaccines over several days despite lack of supporting data. Reported considerations in delaying or spreading out 2-month vaccines were clinical instability, provider preference, lower gestational age, and lower birth weight.

Conclusion This survey substantiates the variability of immunizations practices in the NICU and identifies reasons for this variability. Future studies should inform better practice guidance for immunization of preterm NICU patients based on vaccine safety and effectiveness.

Keywords

immunization - preterm - apnea–bradycardia - neonatal intensive care unit

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