Do you - in your countries vaccinate preterm infants in the same way as term ones? Do you perform first vaccination in hospital or after discharge? Maybe someone could suggest articles about vaccination of preterm babies - indications, contraindications, possible side effects...

In Vienna, we try to stick with the recommended schedule as for term neonates (i.e. at their age, not corrected for prematurity). We might delay by a month if we feel the infant is too sick to be vaccinated at the recommended time. We try to immunize all eligible neonates before discharge, but we do not vaccinate on the day of discharge, as immunizations are associated with higher frequency of apnea. Hacking et al.

Better vaccine coverage if immunizations of preterms is started in the hospital Denizot et al.

Thank you very much for your quick reply and especially for the links. I am also interested in immune response in premature infants. Can you suggest something? Is this very common situation that you observe apnea after immunisation? What can it be related to? To pain for example? Do you use any kind of analgesia? Local - like EMLA ? General - like acetaminophen before injection?

In Sweden (Eskilstuna) we are vaccinating at/after 60 days of life but not before 34 weeks of gestation. So we are starting the vaccination-schedule a bit earlier (DTP, HiB, Polio + Pneumococcal vaccine).

We are arranging the 1st shot within the baby is on the ward and has at least a saturation-control for one night.

If the baby had apnea`s then we arrange the 2nd shot with a 1 night stay at the hospital.

Greetings

Dirk