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PEDIATRICS Vol. 112 No. 1 July 2003, pp. 193-198

CLINICAL REPORT

Immunization of Preterm and Low Birth Weight Infants

Thomas N. Saari, MD and Committee on Infectious Diseases

Preterm (PT) infants are at increased risk of experiencing complications of vaccine-preventable diseases but are less likely to receive immunizations on time. Medically stable PT and low birth weight (LBW) infants should receive full doses of diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, hepatitis B, poliovirus, and pneumococcal conjugate vaccines at a chronologic age consistent with the schedule recommended for full-term infants. Infants with birth weight less than 2000 g may require modification of the timing of hepatitis B immunoprophylaxis depending on maternal hepatitis B surface antigen status. All PT and LBW infants benefit from receiving influenza vaccine beginning at 6 months of age before the beginning of and during the influenza season. All vaccines routinely recommended during infancy are safe for use in PT and LBW infants. The occurrence of mild vaccine-attributable adverse events are similar in both full-term and PT vaccine recipients. Although the immunogenicity of some childhood vaccines may be decreased in the smallest PT infants, antibody concentrations achieved usually are protective.

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Abbreviations: PT, preterm • LBW, low birth weight • VLBW, very low birth weight • ELBW, extremely low birth weight • HBV, hepatitis B virus • DTaP, diphtheria and tetanus toxoids and acellular pertussis • IPV, inactivated poliovirus • Hib, Haemophilus influenzae type b • FT, full-term • PCV7, heptavalent pneumococcal conjugate vaccine • AAP, American Academy of Pediatrics • HBsAg, hepatitis B surface antigen • anti-HBs, antibody to hepatitis B surface antigen • DTwP, diphtheria and tetanus toxoids and whole-cell pertussis • OPV, oral poliovirus • MCV, meningococcal C conjugate vaccine • CLD, chronic lung disease • HBIG, Hepatitis B Immune Globulin

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Statement of reaffirmation:

AAP Publications Retired and Reaffirmed
Pediatrics 123: 1421-1422. [Full Text]

Statement of retirement:

Policy Statement--AAP Publications Retired and Reaffirmed
Pediatrics 124: 845-845. [Full Text]

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