Immunization Strategies to Protect Preterm Infants

Abstract

The development of a safe and effective childhood immunization schedule has effectively reduced morbidity and mortality from vaccine-preventable diseases (VPDs). VPDs are particularly severe in young infants, especially preterm (gestational age <37 weeks) or low birthweight (<2,500 g) infants. Despite established recommendations that preterm infants be immunized on the same schedule as term infants, with a few exceptions for specific vaccines, considerable immunization delays are reported. Studies demonstrate that vaccines are safe and immunogenic in preterm infants. Although the magnitude of immune responses sometimes may be lower for specific vaccines in preterm infants, protective and durable responses are achieved in most cases. For other VPDs that either selectively target (eg, group B Streptococcus) or are particularly severe (eg, pertussis) in preterm and term infants or for which no vaccine is licensed in this age group (eg, influenza), other immunization strategies such as maternal immunization or targeted immunization may reduce morbidity and mortality.