Vaccination rate and age of premature infants weighing <1500 g: a pilot study in north‐western Switzerland

Abstract

In Switzerland, there are no special vaccination recommendations for premature and low‐birthweight infants with respect to a particular target vaccination age. Incomplete and delayed vaccination bears the inherent risk of preventable infections. Therefore, the vaccination rate and age of 60 premature infants in north‐western Switzerland born in 1994/95 were investigated in a retrospective case‐control study. For this group of patients these are the first data ever available for this region. At the age of 4–5 y, the vaccination rates for polio and diphtheria, tetanus, pertussis (DTP acellular) as well as Haemophilus influenzae b (Hib) were similar in both preterm and full‐term infants. In both groups, the fourth dose of vaccine against DTP, Hib and polio was far less frequently administered than the first three. The vaccination age in preterm infants for most vaccinations was significantly higher than in age‐matched full‐term controls. This was particularly obvious for the first dose of vaccine against polio and DTP. In preterm infants, the median age (5th; 95th percentile) at the date of the first polio vaccination was 131 (89; 270) d and 82 (60; 182) in full‐term controls (p &lt; 0.00001). The age difference was even larger for the first DTP vaccination (62 d, p &lt; 0.00001). The main reasons for delayed vaccination may include insufficient information given to parents as well as prolonged hospitalization. Conclusion: Vaccination of preterm infants should be discussed in every discharge communication, with emphasis on vaccine administration at the appropriate chronological age.

Very low birth weight infants have only few adverse events after timely immunization

“…This shows a clear learning effect on physicians that treat these infants. Tillmann et al 7 reported in a group of premature babies in north-western Switzerland a significant delay when compared with full-term controls. This delay was mostly caused by insufficient information to parents about the importance of adequate timing of the vaccination, and the authors speculate that practitioners still believed that pre-term babies should be vaccinated according to their corrected age.…”

Impfstatus bei Frühgeborenen mit einem Geburtsgewicht unter 1500 g im Alter von 2 Jahren – eine deutschlandweite Piloterhebung

“…Deshalb empfehlen Expertengremien wie die STIKO am Robert-Koch-Institut in Berlin, aber auch amerikanische und britische Impfkommissionen, Fr ü hgeborene nach dem chronologischen Alter zu impfen. Erhebungen au ß erhalb Deutschlands konnten bisher zeigen, dass Impfungen bei Fr ü hgeborenen oftmals versp ä tet und mit gro ß en Bedenken durchgef ü hrt werden [5,13,24] . Diese Bedenken zeigten auch die Reaktionen in verschiedenen Internetportalen nach einem Aufruf der Deutschen Gesellschaft f ü r Sozialp ä diatrie und Jugendmedizin (DGSPJ) ab Mai 2009, Fr ü hgeborene zeitgerecht zu impfen.…”

“…Es wurde jedoch darauf hingewiesen, dass Eltern leichte Impfnebenwirkungen eventuell nicht erkannt oder nicht angegeben haben und sich dadurch niedrigere Raten an Nebenwirkungen ergeben k ö nnen als tats ä chlich aufgetreten seien. Ä hnlich verh ä lt es sich in unserer Darstellung von aufgetretenen Nebenwirkungen, da sie sich auf die Aussagen der Eltern st ü tzt und somit keine objektivierte Erfassung ist [24] . Vergleichbare Erkenntnisse bez ü glich der versp ä teten Durchf ü hrung der Impfungen ergab eine Studie aus den USA, die gleichfalls eine sig nifi kante Verz ö gerung der Impfungen bei sehr und extrem Fr ü hgeborenen nachweisen konnten [13] .…”

Acceptance and timeliness of standard vaccination in children with chronic neurological deficits in north-western Switzerland

“…Missed preventive visits, and difficulties in tracking undervaccinated patients play a major role in lacking compliance with recommendations [21]. In addition, children with preexisting medical conditions such as premature birth are vaccinated more reluctantly than full-term born children [22].…”