1 Improvements in neonatal care have resulted in the survival of more infants of lower gestational age. All preterm infants are prone to infection, and infants of lower gestational age with underlying lung disease from long term ventilation are especially susceptible to respiratory pathogens. These infants can benefit greatly from immunisation, and health care providers have a responsibility to ensure that they receive appropriate and timely immunisations. This brief report provides a summary of current knowledge about the safety, efficacy and duration of immunity of the Australian standard schedule vaccines in preterm infants.
Pertussis is a major problem in Australia.
3,4 Hospitalisation and deaths relating to pertussis are more likely to occur in preterm infants. New or increased episodes of apnoea and bradycardia were reported in the 24 - 72 hour period following immunisation for some infants born at 31 weeks gestation. The majority of the apnoeic episodes were minor and self limiting. The authors recommend that all hospitalised preterm infants be commenced on cardiorespiratory monitoring prior to immunisation and that monitoring be continued for at least 48 hours. 16 Acellular pertussis vaccines, now available in Australia and licensed for all age groups, may be better tolerated than whole cell vaccines, but few data are available on their use in preterm infants.