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Right arrow Premature & Newborn

PEDIATRICS Vol. 101 No. 4 April 1998, pp. 597-603

Three-year Follow-up of Vaccine Response in Extremely Preterm Infants

Received Apr 17, 1997; accepted Sep 8, 1997.

Rubia Khalak*, Michael E. PichicheroDagger , and Carl T. D'Angio*

From the * Department of Pediatrics, Neonatology, Strong Children's Research Center, Rochester, New York; and the Dagger  Department of Microbiology and Immunology, University of Rochester, Rochester, New York.

Objective.  To assess whether the adequate antibody response observed in former extremely premature infants after the primary series of immunizations is sustained after the first booster vaccines.

Subjects and Methods.  Sixteen former extremely premature (<29 weeks, <1000 g at birth) and 17 former full-term (>37 weeks) infants had sera obtained for antibody titer measurement at 3 to 4 years of age. All had received the primary series and first booster vaccines for diphtheria, pertussis, tetanus, polio, and Haemophilus influenzae type b. Twelve preterm and 14 full-term children had completed the hepatitis B vaccine series.

Results.  At 3 to 4 years of age, former preterm and full-term children had similar geometric mean titer (GMT) values of antibodies to tetanus, diphtheria, and pertussis. Preterm children had a lower GMT value of Haemophilus polyribosylribitol phosphate (PRP) antibody than did full-term children (0.99 vs 3.06 µg/mL). Fifty percent of preterm and 88% of full-term children had PRP antibody >1.0 µg/mL; 100% of preterm and 94% of full-term children had anti-PRP titers >0.15 µg/mL. GMT values of neutralizing antibodies to polio serotypes 1 and 2 were similar, with 94% to 100% of both groups above protective levels (>= 1:8). The difference in GMT values of polio serotype 3 approached significance (29 vs 73); fewer preterm children had protective titer values (75% vs 100%). Among children vaccinated against hepatitis B, 75% of preterm and 71% of full-term children were protected (10 mIU/mL).

Conclusions.  Preterm children immunized at the recommended chronological ages displayed antibody responses similar to those for full-term children for most immunizing antigens. Responses to PRP and polio serotype 3 were less robust than those of full-term children.

Key words: immunization, polio vaccine, diphtheria-tetanus-pertussis vaccine, Haemophilus influenzae type b vaccine, hepatitis B vaccine.




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