Posted January 28Jan 28 Hello everyone, I am a third-year medical student from Brazil and we recently discussed an insightful retrospective study published in the Journal of Perinatology titled Don't Wait, Vaccinate. It compared the incidence of cardiorespiratory events in preterm infants receiving all routine 2-month vaccines on a single day versus on multiple days. The study found no significant difference in events like prolonged apnea or bradycardia between the groups. Single-day administration, however, reduced schedule interruptions, improving adherence to vaccination timelines. I'd like to hear your thoughts: Have you observed differences in outcomes with single-day vs. multi-day vaccination schedules? What factors should guide this decision in the NICU? Looking forward to your insights! Ep43_vaccine.pdf
January 28Jan 28 In our unit we have always given the vaccines on one day. There is very rarely and adverse event. Occaisional Temperatures and 2-3 times per year infants need slightly more respiratory support secondary to increased apnoes.
January 29Jan 29 @sallest Thank you for bringing up this important study! I'm curious whether units have implemented specific protocols for assessing vaccination readiness, particularly regarding cardiorespiratory stability criteria. No significant events for 48 - 72 hours? Anything else you consider?
January 30Jan 30 Author On 1/28/2025 at 8:27 PM, Sheryle said: In our unit we have always given the vaccines on one day. There is very rarely and adverse event. Occaisional Temperatures and 2-3 times per year infants need slightly more respiratory support secondary to increased apnoes. It’s interesting to hear that you administer vaccines on a single day. I have the impression that this approach indeed helps minimize interruptions to the vaccination schedule for infants. As more studies are conducted and demonstrate that this practice is truly safe with no cardiopulmonary risks, I believe it will become an important strategy to ensure continuity in the vaccination schedule
Friday at 08:07 PM1 day I think it helps that we have a hexavalent DTaP/IPV/ Hib/HepB combination.We observe temperature sometimes, but no serious adverse events.We don't have a specific protocol; we try to administer at the recommended time. If the baby is unstable, we might wait to administer, but they are usually fine at 8 weeks, @piatkat
Yesterday at 07:31 AM1 day We used to give a combination of Hexyon and pneumococcal vaccine but saw some increased desauturations from our pneumococcal vaccine, and the Swedish National Health Agency recommended against early vaccination in preterms.As for now we give Hexyon and RotaTeq (rota only if there are no contraindications e.g born <25 W, intestinal disease or immunosuppressive treatment in mother).For children born <26 W of age at 34 W, 26-32 W at 6 weeks of age. Surveillance with apnea monitor for 48 h post vaccination is warranted. If they get their first vaccination at 10+ weeks of age they will also get Vaxneuvance, but if possible at separate days.The statement from the Swedish national health agency was as follows:”Since the introduction of pneumococcal vaccine into the childhood vaccination programme, the incidence of invasive pneumococcal disease has decreased significantly, and there are now only a few cases in infants annually. Very few cases are caused by vaccine serotypes, probably due to both direct protection and herd effects of the vaccines. An additional dose of pneumococcal vaccine for premature infants is not currently considered to affect the incidence of severe pneumococcal disease in this age group. This may need to be reconsidered in the event of changes in epidemiology and vaccination coverage”
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