More than 1.2 million babies are born prematurely each year in China, the second highest number in the world. These babies are at high risk for growth retardation, infectious diseases, and developmental backwardness.
There are also many premature babies who visit the clinic, and in addition to feeding and growth and development, parents ask the question, “Can my baby get vaccinated?” Others say, “My baby was born 5 months ago and hasn’t had a single vaccination, does it matter?”
We all know that full-term healthy babies are vaccinated against hepatitis B and BCG as soon as possible after birth, while premature babies are born with low weight and in unstable condition, and most cannot be vaccinated immediately after birth.
Can premature babies be vaccinated? When can they be vaccinated?
Premature babies have immature immune function and weak resistance to infection, and some babies even stay in incubators since birth. Some parents say that since their babies were born prematurely, they have had an inseparable relationship with the hospital and often have to go to the hospital. Can such a baby be vaccinated? Some normal full-term babies have reactions to vaccines after they have been vaccinated.
It is this characteristic of premature babies that makes vaccination all the more necessary. According to studies, in most cases, adverse reactions to vaccination are rare in preterm babies, and the differences in safety, tolerance and immune response to conventional vaccines are not statistically significant compared to those in full-term babies. The “Expert Consensus on Vaccination for Children with Special Health Status” and the American Academy of Pediatrics recommend that preterm infants (including low birth weight infants) should be immunized according to the immunization program for full-term infants.
Premature infants with stable vital signs and weight >2 kg can receive all types of vaccines (except BCG vaccine for preterm infants with birth weight <2.5 kg, and BCG vaccine for infants with weight ≥2.5 kg and good growth and development). Critically ill premature infants should receive the first dose of hepatitis B vaccine as soon as their vital signs stabilize.
Detailed explanation of vaccination for preterm infants
1.Hepatitis B vaccine
Most data show that premature infants who receive 3 doses of vaccination can achieve protective levels at 9-12 months after birth. Premature infants with stable vital signs and birth weight <2000 g are not counted in the vaccination schedule for the first dose, that is, after receiving this dose, they are vaccinated again according to 0, 1 and 6 months.
2. Inactivated cremasteric polio vaccine
A large amount of research literature has found that the number of immune cells produced is the same when compared to full-term infants. In other words, the effect is exactly the same.
3.Diphtheria triple vaccine
The production of protection is not affected by being a premature infant. The acellular pertussis vaccine, which has a lower toxin level, can be administered normally to premature infants.
4.Inactivated trivalent influenza vaccine
Recent studies have shown that there is no significant difference in the effect of using a more purified influenza vaccine for premature and full-term infants. Vaccination is often recommended for full-term infants 6 months after birth, but influenza vaccine given to premature infants 6 months after birth can also produce adequate immune protection.
5. MMR varicella vaccine (prevention of measles, mumps, rubella, varicella)
Again, studies have shown no significant difference between preterm and full-term infants.
Should preterm infants be vaccinated according to corrected age or age at birth?
Preterm infants should be immunized according to the same immunization schedule as full-term infants, i.e., preterm infants should be immunized according to their actual age at birth rather than corrected age at birth. The first vaccination remains BCG and Hepatitis B vaccine. Later, other vaccines are given in successive regular intervals according to the time of the first vaccination and the immunization schedule.
Does a premature infant need special care after vaccination?
Routine vaccinations for preterm infants are generally safe and well tolerated and do not increase the incidence of adverse events compared to full-term infants. There is no special post-vaccination care, and the baby should be observed in the same way as a normal full-term baby. Premature infants who are still hospitalized should be observed for 72 hours after vaccination.
Regardless of whether the baby is full-term or premature, it is important to have the pediatrician do a health checkup before each vaccination to assess whether the baby is physically fit for vaccination. Especially for premature babies with immature immune cell function, for each specific vaccination, especially new vaccines and combination vaccines, the baby needs to be evaluated by medical staff before the vaccination can be administered.