Вакцинопрофилактика недоношенных новорожденных: реальная клиническая практика

Abstract

Objective. To analyze the vaccination coverage and adherence to the vaccination schedule among premature newborns with a birthweight of <2,500 g. Patients and methods. This study included 119 children aged 5 to 6 years followed up within the "National prospective multicenter cohort study of newborns" in Tomsk. The experimental group comprised 96 children born prematurely, including 36 low-birthweight (LBW), 25 very low-birthweight (VLBW), and 36 extremely low-birthweight (ELBW) children. The control group included 23 healthy children born full-term. We analyzed their clinical data and information on vaccination. Results. The number of children who had completed their vaccination by the age of 5 years varied across the groups: 34.8% of controls; 16.7% of LBW children; 28% of VLBW children; and 17.1% of ELBW children (p > 0.05). Thirteen percent of controls and 5.6% of LBW children were timely vaccinated, whereas none of the VLBW and ELBW children had their vaccination in time. We observed no differences in the vaccination profiles (types of administered vaccines) between the VLBW children and controls; vaccination profiles of the LBW and ELBW children were similar. ELBW children were less likely to be vaccinated against tuberculosis, pertussis, diphtheria, tetanus, and polio than controls (p < 0.01). None of the ELBW children received vaccines against hepatitis B, pertussis, diphtheria, and tetanus, as well as third vaccine against polio at birth. In the rest of the groups, the proportion of timely vaccinated children did not exceed 20%. Parents in the control group were less likely to refuse vaccination for their children than those in the experimental group. Non-adherence to the vaccination schedule was more common in the LBW children. VLBW and ELBW children had medical exemptions more frequently than LBW children and controls. Conclusion. We observed low vaccination coverage among premature newborns for all vaccines caused both by medical exemption and non-adherence to the vaccination schedule. Key words: vaccination, premature newborns, extremely low birth weight