{"id":1299,"date":"2016-04-12T11:02:52","date_gmt":"2016-04-12T01:02:52","guid":{"rendered":"http:\/\/www.mvec.vic.edu.au\/?page_id=1299"},"modified":"2024-10-22T15:00:54","modified_gmt":"2024-10-22T04:00:54","slug":"preterm-infant-immunisation","status":"publish","type":"references","link":"https:\/\/mvec.mcri.edu.au\/vi\/references\/preterm-infant-immunisation\/","title":{"rendered":"Preterm and low birthweight infants"},"content":{"rendered":"
<\/p>\n

L\u00fd l\u1ecbch<\/h2>\n

Pre<\/span>term<\/span> describes<\/span> infants<\/span> born <\/span>before <\/span>37 weeks<\/span> c\u1ee7a<\/span> thai k\u1ef3 <\/span>l\u00e0<\/span> completed<\/span>; this is also known as prematurity<\/span>.<\/span><\/span><\/p>\n

Being <\/span>very preterm (28 to less than 32 weeks\u2019 gestation), being <\/span>extremely preterm (<\/span>less than <\/span>28 <\/span>weeks<\/span>\u2019<\/span> gestation<\/span>)<\/span> V\u00e0<\/span>\/or<\/span> being <\/span>born with <\/span>low bi<\/span>rthweight<\/span> (<\/span>under 2<\/span>.5<\/span> kg, or 2<\/span>5<\/span>00 g<\/span>)<\/span> are<\/span> t\u1ea5t c\u1ea3<\/span> factors associated with<\/span> poorer health outcomes<\/span>,<\/span> including<\/span> being <\/span>at increased<\/span> risk of <\/span>infection<\/span> and complications<\/span> from <\/span>infections.<\/span><\/span><\/p>\n

Th<\/span>e<\/span> increased risk of infections and complications<\/span> may be due to <\/span>M\u1ed9t<\/span> variety of <\/span>factors<\/span>,<\/span> includ<\/span>

<\/div><\/span> c\u00e1c <\/span>need for <\/span>prolonged <\/span>nh\u1eadp vi\u1ec7n<\/span> V\u00e0<\/span> having<\/span> chronic con<\/span>ditions<\/span> associated with <\/span>low birthweight or <\/span>prematurity<\/span>.<\/span><\/span><\/p>\n

khuy\u1ebfn ngh\u1ecb<\/h2>\n

In addition to the routine vaccines on the<\/span> Ch\u01b0\u01a1ng tr\u00ecnh Ti\u00eam ch\u1ee7ng Qu\u1ed1c gia (NIP)<\/span><\/a>, extremely or very preterm and low birthweight<\/span>\u00a0infants are recommended <\/span>th\u00eam v\u00e0o<\/span> doses and vaccines to ensure <\/span>optimum<\/span> protection. The presence of specific medical conditions may also <\/span>warrant<\/span> administration of other vaccines.<\/span><\/span><\/p>\n

Timing of administration<\/h3>\n

Administration of vaccines to preterm infants should be timed according to chronological age (actual age counted from birth) as opposed to a corrected age (the age an infant would be if they were born on their due date). Timeliness is important to minimise the window preterm infants are not protected from vaccine-preventable diseases. Depending on gestation at delivery, preterm infants may not have had the opportunity to gain the passive protection of ho g\u00e0<\/a>, respiratory syncytial virus (RSV)<\/a>\u00a0V\u00e0

<\/div><\/a> from their mothers in utero.<\/span><\/p>\n

Rotavirus<\/a> vaccination must be administered within a strict timeframe, with the first dose required before turning 15 weeks old (chronological or actual age) and the second dose before 25 weeks of age. There is no catch-up if an infant has missed these cut-off dates.<\/span>\u00a0<\/span><\/p>\n

ph\u1ebf c\u1ea7u khu\u1ea9n<\/span><\/span><\/h3>\n

Infants born at less than 28 weeks’ gestation are at greater risk of invasive pneumococcal disease<\/a>.<\/span><\/p>\n

It is recommended that an <\/span>th\u00eam v\u00e0o <\/span><\/b>dose of Prevenar 13<\/span> (PCV13) be administered at 6 months of age (total of 4 doses, given at 6 weeks, 4 months, 6 months and 12 months of age). They should <\/span>also <\/span><\/b>receive a dose of <\/span>Pneumovax 23<\/span> (PPV23) at 4 years of age.<\/span><\/p>\n

Where there is an ongoing risk for pneumococcal disease (Aboriginal and Torres Strait Islander children or those with specified medical conditions), a <\/span>th\u1ee9 hai <\/span><\/b>(and final) dose of Pneumovax 23 should be administered 5 years after the first dose.<\/span><\/p>\n

B\u1ec7nh vi\u00eam gan B<\/h3>\n

T\u00d4I<\/span>nfants<\/span> born <\/span>weighing<\/span> less than<\/span>\u00a02000<\/span> g<\/span> and infants <\/span>born at less than<\/span> 32 <\/span>weeks<\/span>\u2019<\/span> ge<\/span>station (regardless of birthweight) <\/span>require an <\/span>th\u00eam v\u00e0o<\/span> dose of vaccine to mount<\/span> the same response as <\/span>infants <\/span>born <\/span>of average weight and <\/span>born at term<\/span> receiving a standard course<\/span>.<\/span><\/span><\/p>\n

This <\/span>th\u00eam v\u00e0o<\/span><\/b>\u00a0<\/span>hepatitis B<\/span><\/a>\u00a0dose should be given at 12 months of age (total 5 doses, birth, 6 weeks, 4 months, 6 months and 12 months). The birth dose of hepatitis B can be given up to Day 7 of life (prior to turning 8 days old). There is no catch-up if it is not given by this time.<\/p>\n

Pre- and post-vaccination serology is not routinely required or recommended.<\/span><\/p>\n

C\u00fam<\/h3>\n

Infants born preterm, have a high risk of severe disease and complications from influenza infection<\/a>.<\/span><\/p>\n

Annual vaccination is recommended from 6 months of age. Two doses, a minimum of 4 weeks apart, should be given anyone under 9 years of age in the first year of receiving the influenza vaccine, with a single annual dose recommended in subsequent years.<\/span><\/p>\n

RSV<\/h3>\n

Infants born at less than 32 weeks\u2019 gestation are at increased risk of severe disease and complications if infected with RSV<\/a>.<\/span>\u00a0<\/span><\/p>\n

Regardless of whether their mother was vaccinated against RSV during pregnancy, these infants are recommended to receive RSV immunoglobulin (Nirsevimab). Protection gained from Nirsevimab lasts around 5 months and administration should therefore be timed to optimise protection over the RSV season (April to September).<\/span>\u00a0<\/span><\/p>\n

\u0110\u1ecba ch\u1ec9 li\u00ean h\u1ec7 h\u1ed9 gia \u0111\u00ecnh<\/span><\/span><\/h3>\n

Family members and other household contacts of preterm infants should ensure they are up to date with all recommended vaccines, particularly

<\/div><\/a>, ho g\u00e0<\/a> V\u00e0 COVID-19<\/a>.\u00a0<\/span><\/p>\n

Ph\u1ea3n \u1ee9ng ph\u1ee5<\/h2>\n

In addition to the <\/span>small list of <\/span>common and expected side effects<\/span>,<\/span> apnoea<\/span> (<\/span>pause in<\/span> breathing<\/span>)<\/span> has been reported <\/span>ti\u1ebfp theo <\/span>administration of <\/span>vaccin<\/span>es<\/span> to preterm infants<\/span>. <\/span>\u00a0Most apnoeic events self-resolve<\/span> and are not associated with long-term <\/span>complications<\/span>.<\/span> h<\/span>owever<\/span>,<\/span> there is a small chance of recurrence following future vaccines.<\/span><\/span><\/p>\n

Apnoeas<\/span> and any <\/span>unexpected <\/span>side effects should be reported to <\/span>and followed up by <\/span>c\u00e1c<\/span><\/span> adverse event reporting service<\/span><\/span><\/span><\/a> in your jurisdiction.<\/span><\/span><\/p>\n

Access<\/h2>\n

M\u1ed8T<\/span>dditional<\/span> vaccines recommended to preterm and low birthweight infants <\/span>are<\/span> funded<\/span> via the NIP<\/span> and can be accessed <\/span>through GPs, council immunisation services, Aboriginal Health <\/span>Services<\/span> and specialist immunisati<\/span>on clinics<\/span>.<\/span><\/span><\/p>\n

Different<\/span> Australian<\/span> jurisdic<\/span>tions<\/span> have different approaches to <\/span>RSV immunoglobulin<\/span> programs<\/span><\/a>.<\/span><\/p>\n<\/div>

<\/p>\n

T\u00e0i li\u1ec7u<\/h2>\n