Vaccination timeliness in preterm infants: An integrative review of the literature

Sisson, Helen; Gardiner, Eric; Watson, Roger

doi:10.1111/jocn.13916

Cited by 19 publications

(17 citation statements)

References 29 publications

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“…In conclusion, our results support the current ACIP recommendations to administer the first dose of measles-containing vaccine at age 12 through 15 months for all children, including those born preterm [1,13,31]. Delaying vaccination of measles-containing vaccines may increase the risk of seizures following vaccination.…”

Section: Discussionsupporting

confidence: 83%

“…Additionally, differences in the underlying medical conditions or health-seeking behaviors may exist between those who are vaccinated at the recommended age versus those who receive it later [6]. Parents of preterm infants may delay MMR vaccination for their child [13,14], as the incidence of febrile seizures is higher in children who are born preterm than those born full-term [15–17]. However, data concerning the safety of vaccination in children born preterm compared to children born full-term is limited particularly for vaccinations received during the second year of life [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Similar relative risks of seizures following measles containing vaccination in children born preterm compared to full-term without previous seizures or seizure-related disorders

McClure

Jacobsen

Klein

et al. 2019

Vaccine

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Background: Febrile seizures are associated with the first dose of measles-containing vaccines and the risk increases with chronologic age during the second year of life. We used the Vaccine Safety Datalink (VSD) to determine if the relative increase in risk of seizures following receipt of measles-containing vaccine differs by gestational age at birth. Methods: Children were eligible if they received their first dose of measles-containing vaccine at age 12 through 23 months from January 2003 through September 2015. Children were excluded if they had a history of seizure or conditions strongly related to seizure prior to 12 months of age. Seizures were identified by diagnostic codes in the inpatient or emergency department settings. Using risk-interval analysis, we estimated the incidence rate ratio (IRR) for seizures in the 7 through 10 days (risk period) vs 15 through 42 days (control period) following receipt of measles-containing vaccines in children born preterm (<37 weeks gestation age) and those born full-term (≤37 weeks). Results: There were 532,375 children (45,343 preterm and 487,032 full-term) who received their first dose of measles-containing vaccine at age 12 through 23 months. The IRRs of febrile seizures 7 through 10 days compared with 15 through 42 days after receipt of measles-containing vaccine were 3.9 (95% CI: 2.5–6.0) in preterm children and 3.2 (2.7–3.7) in full-term children; the ratio of IRRs: was 1.2 (0.76–1.9), p = 0.41. IRRs were also similar across gestational age groups, by vaccine type received (measles-mumps-rubella [MMR] or measles-mumps-rubella-varicella [MMRV]) and age at vaccination (12–15 or 16–23 months). Conclusion: Vaccination with a measles-containing vaccine in the second year of life is associated with a similar relative risk of a first seizure in children born preterm as in those who were born full-term.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Similar relative risks of seizures following measles containing vaccination in children born preterm compared to full-term without previous seizures or seizure-related disorders

McClure

Jacobsen

Klein

et al. 2019

Vaccine

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“…16 Another study suggests, as we did, that initiating vaccination in the hospital setting was associated with future vaccination, 38 leading some to speculate that this helped to alleviate parent and provider vaccine safety concerns and helped to instill confidence in vaccinating high-risk infants after hospital discharge. 39 Earlier work has also indicated that parents and providers may have limited knowledge of and adherence to vaccine recommendations for preterm infants. 15,34,[40][41][42][43] One study revealed that less than half of parents knew that preterm infants should be vaccinated at the same age as term infants, 40% thought the extent of prematurity influenced timing of vaccination, and 25% believed a minimum weight needed to be reached before vaccination.…”

Section: Discussionmentioning

confidence: 99%

Early Childhood Vaccination Status of Preterm Infants

et al. 2019

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BACKGROUND: Preterm infants are at increased risk for vaccine-preventable infections and associated complications. Limited studies describe timely vaccination of these vulnerable infants. METHODS: This retrospective cohort study included Washington State infants with birth hospitalizations at an urban academic medical center between 2008 and 2013. Demographic, clinical, and visit data from electronic health records were linked to vaccine data from the Washington State Immunization Information System. Completion of the recommended 7vaccine series by 19 months of age was compared between preterm infants (born at ,37 weeks' gestation) and term/postterm infants (born at 37-43 weeks' gestation) by using Pearson's x 2 test and multivariable logistic regression. Secondary outcomes included 7vaccine series completion by 36 months of age and receipt of individual vaccines in the series. Rotavirus, hepatitis A, and influenza vaccination was also assessed. RESULTS: Of study infants (n = 10 367), 19.3% were born prematurely. Preterm infants had lower 7-vaccine series completion compared with term/postterm infants by 19 months (47.5% vs 54.0%; adjusted odds ratio 0.77 [95% confidence interval 0.65-0.90]) and 36 months (63.6% vs 71.3%; adjusted odds ratio 0.73 [95% confidence interval 0.61-0.87]). Early preterm (23-33 weeks' gestation) and late preterm (34-36 weeks' gestation) infants had a lower rate of 7-vaccine series completion compared with term/postterm infants. Full influenza vaccination coverage by 19 months also differed between groups (early preterm: 47.7%; late preterm: 41.5%; term/postterm: 44.7%; P = .02). CONCLUSIONS: Over half of preterm infants were undervaccinated at 19 months; one-third failed to catch up by 36 months. Strategies to improve vaccination of these high-risk infants are needed. WHAT'S KNOWN ON THIS SUBJECT: Preterm infants are at an increased risk for vaccine-preventable infections and associated complications. Earlier work reveals that they may also be at risk for undervaccination, yet studies in which timely receipt of all currently recommended vaccines is examined in this population are lacking. WHAT THIS STUDY ADDS: This study revealed that fewer preterm infants completed the recommended 7-vaccine series by 19 months of age compared with term/postterm infants. These high-risk infants continued to lag behind in vaccination coverage at 36 months of age.

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“…Indeed, not only do preterm newborns have immunologic immaturities, but they are deprived of maternal antibodies. The risk of delay in vaccine administration is high and increases with decreasing gestational age at birth [88]. Given their higher vulnerability, preterm infants also benefit from influenza vaccine (as of 6 months of age) and passive immunization against respiratory syncytial virus (RSV).…”

Section: Protecting the Most Vulnerable: How Intensive Care Physicianmentioning

confidence: 99%

Missed vaccinations and critical care admission: all you may wish to know or rediscover—a narrative review

et al. 2019

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Most vaccines are so effective that they could lead to the control/elimination of the diseases they target and directly impact on intensive care admissions or complications. This is best illustrated by the use of vaccines against Haemophilus influenzae type b, Streptococcus pneumoniae, zoster, yellow fever, Ebola virus, influenza or measles-but also by third party strategies such as maternal, toddler and care-giver immunization. However, each of these vaccine-induced protection is threatened by insufficient vaccine uptake. Here, we briefly discuss how vaccine hesitancy has led to the resurgence of diseases that were considered as controlled and explore the effect of vaccine-hesitant healthcare workers on nosocomial infections. As intensive care physicians are in charge of polymorbid patients, we briefly summarize the current recommendations for vaccinations in high-risk patients. We finally give some perspective on ongoing research, and discuss how institutional policies and intensive care physicians could play a role in increasing the impact of vaccination, overall and in intensive care units.

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Vaccination timeliness in preterm infants: An integrative review of the literature

Cited by 19 publications

References 29 publications

Similar relative risks of seizures following measles containing vaccination in children born preterm compared to full-term without previous seizures or seizure-related disorders

Similar relative risks of seizures following measles containing vaccination in children born preterm compared to full-term without previous seizures or seizure-related disorders

Early Childhood Vaccination Status of Preterm Infants

Missed vaccinations and critical care admission: all you may wish to know or rediscover—a narrative review

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