Abstract
This study is aimed at detecting the rate of untimely immunization in a large cohort of extremely low gestational age neonates (ELGANs) of the German Neonatal Network (GNN) and at addressing risk factors for delayed vaccination and associated long-term consequences. We performed an observational study of the GNN between 1st January 2010 and 31st December 2019. The immunization status for the hexavalent and pneumococcal immunization was evaluated in n = 8401 preterm infants <29 weeks of gestation. Univariate analysis and logistic/linear regression models were used to identify risk factors for vaccination delay and outcomes at a 5-year follow-up. In our cohort n = 824 (9.8%) ELGANs did not receive a timely first immunization with the hexavalent and pneumococcal vaccine. Risk factors for delayed vaccination were SGA status (18.1% vs. 13.5%; OR 1.3; 95% CI: 1.1–1.7), impaired growth and surrogates for complicated clinical courses (i.e., need for inotropes, necrotizing enterocolitis). At 5 years of age, timely immunized children had a lower risk of bronchitis (episodes within last year: 27.3% vs. 37.7%; OR 0.60, 95% CI: 0.42–0.86) but spirometry measures were unaffected. In conclusion, a significant proportion of ELGANs are untimely immunized, specifically those with increased vulnerability, even though they might particularly benefit from the immune-promoting effects of a timely vaccination.
Highlights
Preterm infants are at high risk for infectious diseases early in life, which often require hospital re-admission [1]
Apart from specific protection against vaccine-preventable diseases, it is discussed whether immunizations in pregnant women and postnatal immunizations elicit non-specific immune training effects which contribute to the prevention of infectious diseases in general [7,8,9,10]
In a large cohort of extremely low gestational age neonates (ELGANs) born in the German Neonatal Network (GNN), we addressed the hypothesis that a neonatologist would pay attention to a timely immunization in particular to ELGANs at higher risk for long-term morbidity
Summary
Preterm infants are at high risk for infectious diseases early in life, which often require hospital re-admission [1]. Influencing mechanisms between the immune system and the infant’s microbiome are prone to preterm birth-related disturbances (i.e., frequent antibiotic exposure and sepsis) and play a key role in achieving robust and sustainable immunity. When it comes to gut colonizationderived immunity, animal models point at an age-dependent “window of opportunity” to promote optimal immune function [15]. Studies suggest that in addition to interventions targeting antigen-specific immunity, non-pathogen-specific cell autonomous immunity (CAI), nutritional and innate immune functions can be harnessed to prevent infectious diseases in early and later infancy [16]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
