Study Confirms that Infants Born Extremely Premature Should Adhere to Normal Immunization Schedule

April 06, 1998

Researchers from the Strong Children's Research Center at the University of Rochester have published a study in the April issue of Pediatrics, the monthly journal of the American Academy of Pediatrics, which confirms that premature and low-birth weight infants should receive their immunizations at the same ages recommended for healthy, full-term babies. The study, which validates the current practice, represents the first long-term research on the topic.

Rubia Khalak, M.D., Micheal Pichichero, M.D. and Carl D'Angio, M.D. are co-authors of "Three Year Follow-up of Vaccine Response in Extremely Preterm Infants," a study comparing 16 former extremely premature and 17 former full-term infants at three to four years of age. The extremely premature infants had all weighed less than 1000 grams and were less than 29 weeks gestation at birth. All of the infants had received the primary immunization series and first booster vaccines for diphtheria, pertussis, tetanus, polio and Haemophilus influenzae type b (Hib) at the normal recommended ages after birth.

The study's authors found that the children born extremely premature who received immunizations on the same schedule as those born at a normal gestation had the same levels of antibodies as children who were full-term newborns. Not only were the children protected from vaccine-preventable diseases, but the preterm newborns, like their full-term counterparts, had no adverse reactions to the primary vaccinations or the booster shots. The study concluded that even the least immunologically mature preterm infants had adequate immune responses that lasted until age three to four.

The issue of whether a premature baby should have immunizations delayed to "correct" for early delivery has long been the source of debate among pediatricians. "Just a few years ago, pediatricians had no real guidelines in this area," Khalak said. "Then short-term studies showed that vaccines when given on the normal schedule were effective in creating immunity without adverse reactions. This study now confirms that immunity endures at least until the children reach school age."

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