What contraindications should be paid attention to inoculation of premature infants
Preterm infants have a greater risk of infection than full-term infants, and there are some contraindications to vaccination of preterm infants.
Six precautionary contraindications for vaccination of premature babies. Many mothers of premature babies and low-weight babies write to ask, and normal term babies only need to be vaccinated on time according to the national immunization planning procedures, but how should vaccination of premature and low-weight babies be done?
What needs attention?
To this end, the reporter interviewed Niu Jianmin, chief physician of the obstetrics department of the Guangdong Provincial Maternal and Child Health Hospital. He introduced to readers the contraindications to immunization of preterm infants.
According to Niu Jianmin, the growth and development of premature infants lags behind that of term infants, and is particularly prominent in the immune system. The functions of T cells and B cells (both immune cells) are more immature than term infants.
The use of steroids before and after birth and lower body weight can result in a lower immune response to some vaccines in preterm infants.
Nevertheless, we should immunize premature babies as soon as possible, because premature babies are at greater risk of infection than full-term babies.
The following are some of the common vaccination precautions: Hepatitis B vaccine Low-weight preterm infants (≤ 2000g) have lower seroconversion rates when vaccinated against hepatitis B vaccine.
But by the age of one month, all premature babies, regardless of weight at birth and pregnancy, have almost the same response to the vaccine as normal babies.
However, babies born to mothers with positive hepatitis B antigen or mothers with unknown infection status must be vaccinated within 12 hours of birth, even if they are premature.
If the newborn weighs less than 2000g, the first dose of the vaccine should not be counted in the immunization program. When the baby reaches 1 month of age, 3 doses of the hepatitis B vaccine should be re-vaccinated.
Because the immune response to HBV in preterm infants is lower than that in term infants, premature infants with a gestational age less than 32 weeks should be tested for serology at 7 months of age. If the antibody concentration is low, booster vaccination is required.Hepatitis B vaccination with 4 doses in June, June and December (only for children whose mothers have not been infected with hepatitis B virus).
Hib vaccine 的 Studies of Hib vaccine in preterm and very preterm infants showed no significant difference in anti-PRP antibodies produced by preterm infants.
Very preterm infants with a gestational age of less than 28 weeks need a booster injection at 6 months of age after receiving Hib vaccine.
无细胞百日咳疫苗 1999年Schloesser等报告，早产儿在2月龄接种2组分百日咳疫苗间隔2~4个月完成所有3针免疫后，早产儿(25~35周)对百日咳毒素和丝状血The lectin’s immune response was significantly lower.
Group C meningococcal conjugate vaccine (MCC) Slaek et al compared the immune response to MCC in term and preterm infants in the UK. The results showed that preterm and term infants had the same good immune response to MCC.
Therefore, preterm infants can get this vaccine at the normal time.
Pneumococcal vaccine premature infants less than 28 weeks of gestational age are at high risk of invasive pneumococcal disease.
Shinefield et al. Conducted a 7-valent pneumococcal vaccine immunogenicity study in 38,000 infants.
The study found no significant differences in the immune responses of term and preterm infants to all seven pneumococcal types.
Preterm infants should receive 3 doses of 7-valent pneumococcal conjugate vaccine at 2, 4 and 6 months of age, 4 shots at 12 months of age, and 1 shot of 23-valent pneumococcal polysaccharide vaccine at 4-5 years of age.
BCG vaccine should not be given to preterm infants with a birth weight <2500g. 白百破三联疫苗 虽然早产儿接种百日咳疫苗后抗体水平低于足月儿，但白喉、破伤风类毒素的免疫原性很强，早产儿的白喉和破伤风抗体水平与足月儿相仿，而且The antibodies required to prevent pertussis, diphtheria, and tetanus are not too high, so you can vaccinate according to the current immunization program. Poliomyelitis vaccine (OPV): At present, oral attenuated polio vaccine (OPV) is used in China. Studies have shown that vaccinating OPV to older preterm infants according to current immunization procedures can induce a sufficient immune response. From the time of discharge, three doses of OPV were given to very preterm infants to induce protective antibodies against all three serotypes.