Apnea after immunization of preterm infants

Sánchez, Pablo J.; Laptook, Abbot R.; Fisher, Linda; Sumner, Janet; Risser, Richard C.; Perlman, Jeffrey M.

doi:10.1016/s0022-3476(97)80017-0

Cited by 66 publications

(50 citation statements)

References 14 publications

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“…The incidence of apnoea in hospitalised preterm infants following immunisation with DTPw-Hib combination vaccines has been reported to be in the range of 7% to 23% [2,8,9]. Studies reporting no increased risk of apnoea in preterm infants after the first DTPw vaccination were based on parents' diaries in outpatient settings [1,7].…”

Section: Discussionmentioning

confidence: 99%

“…Concerns have been raised after the recognition of clinically significant apnoea following the immunisation of hospitalised preterm infants with diphtheria (D), tetanus (T), whole cell pertussis (Pw), and Haemophilus influenzae type B (Hib) component vaccines [2,8,9]. Recent studies have shown similar cardiorespiratory events after administration of combination vaccines containing an acellular pertussis (Pa) component in cohorts of former preterm infants with a large proportion of infants on respiratory support or supplemental oxygen at the time of immunisation, both known to be risk factors for post-immunisation apnoea [3,6,10].…”

Section: Introductionmentioning

confidence: 99%

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Apnoea and bradycardia in preterm infants following immunisation with pentavalent or hexavalent vaccines

et al. 2005

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Although most infants tolerated immunisation well, the incidence of recurrent or increased apnoea or bradycardia in respiratory stable preterm infants following the first immunisation with penta- or hexavalent vaccines was 13%. Most apnoea or bradycardia events required intervention but did not have serious consequences. Monitoring of all preterm infants following immunisation in the neonatal intensive care unit is recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Apnoea and bradycardia in preterm infants following immunisation with pentavalent or hexavalent vaccines

et al. 2005

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“…[1][2][3] Immunization in the NICU has been associated with local reactions, increased irritability, decreased feeding and apnea. [4][5][6][7][8][9][10][11] Several observational studies have shown that infants with adverse reactions after immunization are evaluated for sepsis. 7,8,11,12 In the NICU, clinical suspicion of sepsis may arise in infants with fever, hypothermia, apnea, bradycardia, tachycardia or decreased feeding.…”

Section: Introductionmentioning

confidence: 99%

Risk of fever and sepsis evaluations after routine immunizations in the neonatal intensive care unit

et al. 2010

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Objective: Premature infants can experience cardiorespiratory events such as apnea after immunization in the neonatal intensive care unit (NICU). These changes in clinical status may precipitate sepsis evaluations. This study evaluated whether sepsis evaluations are increased after immunizations in the NICU.Study Design: We conducted a retrospective cohort study of infants older than 53 days who were vaccinated in the NICU at the KPMCP (Kaiser Permanente Medical Care Program). Chart reviews were carried out before and after all immunizations were administered and for all sepsis evaluations after age 53 days. The clinical characteristics of infants on the day before receiving a sepsis evaluation were compared between children undergoing post-immunization sepsis evaluations and children undergoing sepsis evaluation at other times. The incidence rate of sepsis evaluations in the post-immunization period was compared with the rate in a control time period not following immunization using Poisson regression.Result: A total of 490 infants met the inclusion criteria. The rate of fever was increased in the 24 h period after vaccination (2.3%, P<0.05). The incidence rate of sepsis evaluations was 40% lower after immunization than during the control period, although this was not statistically significant (P ¼ 0.09). Infants undergoing a sepsis evaluation after immunization were more likely to have an apneic, bradycardic or moderate-to-severe cardiorespiratory event in the day before the evaluation than were infants undergoing sepsis evaluations at other times (P<0.05). Conclusion:Despite an increase in fever and cardiorespiratory events after immunization in the NICU, routine vaccination was not associated with increased risk of receiving sepsis evaluations. Providers may be deferring immunizations until infants are clinically stable, or may have a higher threshold for initiating sepsis evaluations after immunization than at other times.

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“…Entretanto, também houve reações cardiorrespiratórias graves, que exigiram estímulo vigoroso, suplementação de oxigênio e, em um caso, uso breve de suporte ventilatório manual. A análise de fatores associados a reações cardiorrespiratórias no período pós-imunização, conforme realizada em diversos estudos retrospectivos, obteve observações semelhantes [5][6][7][8][9][15][16][17][18] . Recorrência de apneia após a segunda vacinação foi relatada em 18% para recém-nascidos pré-termo 19 .…”

Section: Discussionunclassified

“…Estudos prévios da vacina de células inteiras contra coqueluche relataram sobre eventos cardiorrespiratórios (ou seja, recorrência de apneia, bradicardia ou dessaturações de SpO 2 ) em recém-nascidos pré-termo [2][3][4][5][6] . Em estudos publicados recentemente, foi usada uma vacina acelular contra coqueluche, mas também foram relatadas reações adversas semelhantes [7][8][9][10][11][12] .…”

Section: O Comitê Consultivo De Práticas De Imunização (Acip) Dosunclassified

Adverse cardiorespiratory events following primary vaccination of very low birth weight infants

Meinus¹,

Schmalisch²,

Hartenstein³

et al. 2012

J Pediatr (Rio J)

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Objective: To examine the relationship between primary vaccination of preterm infants and prevalence ratios of associated factors for unwanted cardiorespiratory events, following the recommendation of the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices for immunization of preterm infants at 2 months of chronological age.Methods: Two-year retrospective study of very low birth weight infants receiving their primary vaccination. Major cardiorespiratory events, such as apnea, bradycardia, SpO 2 desaturation, and minor adverse events, such as temperature instability, poor handling and local reactions, were recorded. Prevalence ratio with 95% confidence interval for associated factors between infants with and without cardiorespiratory events was calculated.Results: Eighty neonates were studied (median [range] birth weight 970 g [428-1,490]), gestational age of 27.4 weeks (23.3-33). Adverse reactions occurred in 35 (44%) patients: minor events in 19 (24%), major events in 28 (35%). Infants with major events had significantly lower gestational age (p = 0.008) and a higher incidence of bronchopulmonary dysplasia (71% vs. 48%; p < 0.05). In very low birth weight infants with major events, O 2 desaturations before vaccination were 3.40 (1.41-8.23) times higher and treatment with methylxanthines for apnea and bradycardia syndrome was 8.05 (2.50-25.89) times higher compared to infants without major events. Conclusion:Major cardiorespiratory events occurred in over 1/3 of all very low birth weight infants after vaccination. Associated factors were low gestational age, bronchopulmonary dysplasia, methylxanthine treatment, and persisting O 2 desaturations before vaccination. Primary vaccination of very low birth weight infants should be performed under continuous monitoring of vital parameters. J Pediatr (Rio J)

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Apnea after immunization of preterm infants

Cited by 66 publications

References 14 publications

Apnoea and bradycardia in preterm infants following immunisation with pentavalent or hexavalent vaccines

Apnoea and bradycardia in preterm infants following immunisation with pentavalent or hexavalent vaccines

Risk of fever and sepsis evaluations after routine immunizations in the neonatal intensive care unit

Adverse cardiorespiratory events following primary vaccination of very low birth weight infants

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