Prematurity, particularly extreme prematurity (< 28 weeks gestation) and low birth weight infants often have associated chronic (special risk) medical conditions. This can be associated with prolonged hospitalisation and frequent clinic visits. These are some of the reasons premature infants are at a greater risk of vaccine preventable diseases (VPDs) and their complications. Preterm infants may also not respond as well to some vaccines (e.g. Hepatitis B)

Immunisation recommendations

Infants should be immunised according to the recommended immunisation schedule based on their chronological age as opposed to their corrected age. This is because it is important to minimise the window preterm infants are not protected from VPDs. Specific special risk medical conditions, as well as birth weight need to be taken into account as extra vaccines may be required .

It should be noted that the Rotavirus immunisation must be given within a strict time frame, with the first dose required before turning 15 weeks (chronological age) and the second dose before 25 weeks of age.

Additional vaccines recommended:

< 28 weeks gestation

  • An extra Pneumococcal Conjugate Vaccine (Prevenar 13) should be given at 6 months of age (a total of 4 doses)
  • Pneumococcal Polysaccharide Vaccine (Pneumovax 23) should be given at 4 years of age

< 32 weeks gestation and/or < 2000g birth weight

  • Hepatitis B vaccine should be given at 12 months of age

Underlying medical condition

  • Influenza vaccine should be given annually from 6 months of age
  • An extra Pneumococcal Conjugate Vaccine (Prevenar 13) should be given at 6 months of age
  • Pneumococcal Polysaccharide Vaccine (Pneumovax 23) should be given at 4 years of age

Household contacts

It is recommended that family members of premature infants be fully up to date with their immunisations including influenza and pertussis boosters. This concept of ‘cocooning’ will help protect vulnerable preterm infants from VPDs.


Reviewed by:  Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute) and Rachael McGuire (SAEFVIC Research Nurse, Murdoch Children’s Research Institute)

Date: June 2018

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.