For most up to date changes, see http://www.cdc.gov/vaccines/schedules/and Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2012 Report of the Committee on Infectious Diseases. 29th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2012.
IMMUNIZATIONS FOR TERM INFANTS
Term infants follow the recommended immunization schedule for persons aged 0–6 years (http://www.cdc.gov/vaccines/schedules/downloads/child/0-6yrs-schedule-pr.pdf).
IMMUNIZATIONS FOR PRETERM INFANTS
Misconceptions about the safety and efficacy of vaccinations for preterm infants have led to delays in immunization for these infants. It is important that preterm infants with prolonged hospital stays begin necessary immunizations prior to neonatal intensive care unit (NICU) discharge to allow development of early protection from infectious agents prevalent in the community, especially pertussis. The American Academy of Pediatrics current recommendations can be summarized as follows:
“Preterm infants born at less than 37 weeks gestation and infants of low birthweight (<2500 grams) should, with few exceptions, receive all routinely recommended childhood vaccinations at the same chronologic age as term infants” even if they are still hospitalized. “Gestational age and birthweight are not limiting factors when deciding whether a clinically stable preterm infant is to be immunized.” In addition, “vaccine doses given to term infants should not be reduced or divided when given to preterm or low birth weight infants.”
IMMUNIZATIONS FOR PRETERM INFANTS
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Table E–1. IMMUNIZATIONS FOR PRETERM INFANTS
|Age ||Infection Prevented ||Recommended Vaccine |
|Birth ||Hepatitis Ba || |
>2000 g birthweight, medically stable, mom Hep B antigen negative:
Hep B monovalent vaccineb at birth or shortly thereafter
>2000 g birthweight, medically unstable, mom Hep B antigen negative: defer Hep B immunization until stable clinical condition
<2000 g birthweight, ≥30 days of chronologic age: Hep B monovalent vaccine,b dose 1 at 30 days chronologic age, if medically stable
<2000 g birthweight, <30 days chronologic age at hospital discharge, give Hep B monovalent vaccineb at discharge
|1–2 months ||Hepatitis Ba ||Give the second dose of Hep B vaccine at 1–2 months of agec |
|2 monthsd || |
Diphtheria, Pertussis, Tetanus
Haemophilus influenzae type b
Rotavirus vaccine can be given to preterm infants as follows: medically stable, between 6 weeks and <15 weeks, with first dose given at hospital discharge, or after discharge—series should not be started after 15 weeks of agef
|4 months ||All of those listed for 2 months ||All of those listed for 2 months except Hep B: if using monovalent Hep B, no vaccine at 4 months. If using a combination vaccine with Hep B, then acceptable to have baby receive a total of 4 doses of Hep B vaccine |
|6 months || |
All of those listed for 2 months
All of those listed for 2 months, except: if PedvaxHIB or Comvax is administered at 2 and 4 months, a dose at 6 months for Hib not necessary
Inactivated influenza vaccine, 2 doses beginning at 6 months of age, with second dose 1 month later
|Hospital discharge ||RSV ||Appropriately selected preterm infants may benefit from immunoprophylaxis with palivizumab beginning at hospital discharge and then monthly during RSV season. Refer to yearly regional recommendations for guidelines |
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