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American Academy of Pediatrics
Article

Antibody Response of Low Birth Weight Infants to Haemophilus influenzae Type b Polyribosylribitol Phosphate-Outer Membrane Protein Conjugate Vaccine

Angel Munoz, Agnes Salvador, Nancy L. Brodsky, Allan M. Arbeter and Rachel Porat
Pediatrics August 1995, 96 (2) 216-219;
Angel Munoz
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Agnes Salvador
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Nancy L. Brodsky
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Allan M. Arbeter
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Rachel Porat
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Abstract

Objective. To evaluate the effectiveness in low birth weight (LBW) infants of the currently recommended immunization schedule for conjugated Haemophilus influenzae type b (HIB) vaccine.

Methods. We quantified antibody responses in 36 preterm infants with a mean birth weight of 1060 g and a mean gestational age of 28 weeks. Infants were immunized with 0.5 mL of HIB vaccine at 2 and 4 months' postnatal age. Specific HIB antibodies were quantified on cord blood, immediately before each immunization and 2 months after the last immunization.

Results. Even though the geometric mean titers increased significantly during the study period, they were still markedly lower than values reported in term infants. After the second immunization, only 24 infants (67%) attained antibody concentrations of more than 0.25 µg/mL, defined as seropositivity. Also, only 53% of infants achieved antibody concentrations of more than 1.0 µg/mL compared with 92% as reported in term infants. Stepwise logistic regression identified gestational age of 27 weeks or less and the amount of intravenous immunoglobulin received as the significant variables influencing the antibody response after the first immunization. The incidence of side effects was negligible.

Conclusions. We conclude that LBW infants, and especially those born at 27 or less weeks' gestation, do not respond as effectively to the HIB vaccine. We speculate that reevaluation of the current immunization schedule may be required for very LBW infants.

  • Received March 17, 1994.
  • Accepted November 7, 1994.
  • Copyright © 1995 by the American Academy of Pediatrics

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Pediatrics
Vol. 96, Issue 2
1 Aug 1995
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Antibody Response of Low Birth Weight Infants to Haemophilus influenzae Type b Polyribosylribitol Phosphate-Outer Membrane Protein Conjugate Vaccine
Angel Munoz, Agnes Salvador, Nancy L. Brodsky, Allan M. Arbeter, Rachel Porat
Pediatrics Aug 1995, 96 (2) 216-219;

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Antibody Response of Low Birth Weight Infants to Haemophilus influenzae Type b Polyribosylribitol Phosphate-Outer Membrane Protein Conjugate Vaccine
Angel Munoz, Agnes Salvador, Nancy L. Brodsky, Allan M. Arbeter, Rachel Porat
Pediatrics Aug 1995, 96 (2) 216-219;
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  • Factors That Influence the Immune Response to Vaccination
  • Immunization Issues in Preterm Infants: Pertussis, Influenza, and Rotavirus
  • Decreased expression of tumor necrosis factor family receptors involved in humoral immune responses in preterm neonates
  • Antipolyribosyl Ribitol Phosphate Response of Premature Infants to Primary and Booster Vaccination With a Combined Diphtheria-Tetanus-Acellular Pertussis-Hepatitis B-Inactivated Polio Virus/Haemophilus influenzae Type b Vaccine
  • Immunisation of premature infants
  • Response of Preterm Newborns to Immunization With a Hexavalent Diphtheria-Tetanus-Acellular Pertussis-Hepatitis B Virus-Inactivated Polio and Haemophilus influenzae Type b Vaccine: First Experiences and Solutions to a Serious and Sensitive Issue
  • The Immunologic Basis for Neonatal Immunizations
  • Risk of life threatening apnoea after immunisation
  • Antibody Response to Diphtheria-Tetanus-Pertussis Immunization in Preterm Infants Who Receive Dexamethasone for Chronic Lung Disease
  • Immunization of Preterm and Low Birth Weight Infants
  • Allergy, immunity, and infection
  • Hib vaccination in infants born prematurely
  • Effect of a fourth Haemophilus influenzae type b immunisation in preterm infants who received dexamethasone for chronic lung disease
  • Seven-Year Follow-up of Vaccine Response in Extremely Premature Infants
  • Hepatitis B Vaccination of Premature Infants: A Reassessment of Current Recommendations for Delayed Immunization
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