Hexavalent vaccines in preterm infants: an update by Italian Society of Pediatric Allergy and Immunology jointly with the Italian Society of Neonatology

Abstract

Hexavalent vaccines, protecting against six diseases (diphtheria, tetanus, pertussis [DTaP], poliovirus, hepatitis B virus [HBV], and Haemophilus influenzae type b [Hib], are routinely the standard of care in Europe. The use of combined vaccines allows the reduction of number of injections and side effects, the reduction of costs, and the increase in adherence of the family to the vaccination schedule both in terms of the number of doses and timing. The safety profile, efficacy and effectiveness of hexavalent vaccines have been extensively documented in infants and children born at term, and data are accumulating in preterm infants. Hexavalent vaccines are particularly important for preterm infants, who are at increased risk for severe forms of vaccine preventable diseases. However, immunization delay has been commonly reported in this age group. All the three hexavalent vaccines currently marketed in Italy can be used in preterm infants, and recent data confirm that hexavalent vaccines have a similar or lower incidence of adverse events in preterm compared to full-term infants; this is likely due to a weaker immune system response and reduced ability to induce an inflammatory response in preterm infants. Apnoea episodes are the adverse events that can occur in the most severe preterm infants and / or with history of respiratory distress. The risk of apnoea after vaccination seems to be related to a lower gestational age and a lower birth weight, supporting the hypothesis that it represents an unspecific response of the preterm infant to different procedures. High seroprotection rates have been reported in preterm infants vaccinated with hexavalent vaccine. However, a lower gestational age seems to be associated with lower antibody titres against some vaccine antigens (e.g. HBV, Hib, poliovirus serotype 1, and pertussis), regardless of the type of hexavalent vaccine used. Waiting for large effectiveness studies, hexavalent vaccines should be administered in preterm infants according to the same schedule recommended for infants born at term, considering their chronological age and providing an adequate monitoring for cardio-respiratory events in the 48–72 h after vaccination, especially for infants at risk of recurrence of apnoea.

Retracted: Deceptology in cancer and vaccine sciences: Seeds of immune destruction‐mini electric shocks in mitochondria: Neuroplasticity‐electrobiology of response profiles and increased induced diseases in four generations – A hypothesis

“…Often, credible sci- gov/vaccines-blood-biologics/vaccines/ § § § § § § § https://pfe-pfizercom-d8-prod.s3.amazonaws.com/2020-09/C4591001_Clinical_Protocol.pdf entific information that is prepared by scientists who work in the government or academia are ignored, dismissed or abused when members of the establishment decide to publicize drugs or vaccines of their choice. [1][2][3][4][5][6][7][8][10][11][12][13]17,18,34,[36][37][38][39]64,69,71,77,94,143,149,169,172,176,178,[180][181][182][183][184][186][187][188][189][190][191][192][193][194][195][196][197] In general, diversities and extent of immune disorders [acute inflammatory res...…”

“…Depending on evolving pathogenic components (eg, molecular envelop glycoproteins, receptor or surface molecules) or host exposure tissue sites, as well as the health status or the age of individual in responding to pathogenic components, or how vaccines are developed (eg, composition of the incipient or engineered viral modifications [DNA or RNA]) could induce additional complicated and unknown electrochemical immune responses. 1,5,8,12,14,19,20,22,32,62,106,129,162,172,177,185,194…”

“…As shown below, pathogen‐specific vaccines (eg, polio, swine flu, hepatitis a, b, c, MMRs, meningitis, shingles, anthrax, pertussis, HPV, SARS, Ebola, Zika, or ‘covid‐19’) and incipient weaken/destroy the complex electrobiology of immunity and Not Promote It ! 1,5,8,11,17,20,27–178 …”

“…The concept of vaccination, or rather immunization, for protecting, promoting and defending individual health against viruses, bacteria or parasites developed in the eighteenth century, well before the important theory of immune surveillance was developed, and before better hygiene or antibiotics improved public health and reduced many preventable infectious diseases and increased longevity. The concept of protecting public health by immunization also existed before Rockefeller patent medicine and Gates patent vaccines invested a great deal in medical education to influence promotion of drug sale and to vaccinate the public with pathogen‐specific vaccines in toxic media and associated debates and controversies 1,2,4,5,12,13,17,18,20‐24,28,30‐33,36‐40,59‐63,66‐68,70,73,77,83,93,94,96,97,110,111,116,128,136‐144,146‐150,156,158,160‐166,168‐172,174,175,181,189‐197,205,206,212 …”

Maternal Immunization: Nature Meets Nurture

“…It is well established that age and sex affect vaccine-induced immunity, particularly quantitative antibody responses, relevant to both the pregnant woman and her developing infant (Baxter et al, 2010;Omeñaca et al, 2018;Chiappini et al, 2019;López-Sanguos et al, 2019).…”