Issue: August 2015
July 13, 2015
1 min read
Save

Vaccines raise risk for adverse events in extremely low birth weight infants

Issue: August 2015
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Research suggests that routine immunizations of extremely low birth weight infants in neonatal ICUs is associated with increased adverse events.

“The immunization of extremely low birth weight infants has been associated with adverse events, including fever and adverse cardiorespiratory events, such as apnea and bradycardia, in the immediate postimmunization period,” researcher Stephen D. DeMeo, DO, of the department of pediatrics at Duke University School of Medicine, and colleagues wrote.

They conducted a multicenter retrospective cohort study of 13,926 extremely low birth weight (ELBW; ≤1,000 g) patients from 345 NICUs to determine the relationship between immunization and the increased rate of adverse events. All patients received at least one immunization, with 91.2% having received three or more immunizations.

The incidence of adverse events rose sharply during the analyzed postimmunization periods. This included sepsis evaluation that increased from 5.4 per 1,000 patient-days preimmunization, to 19.3 per 1,000 patient-days in the postimmunization period (adjusted rate ratio = 3.7; 95% CI, 3.2-4.4). The increased risk for sepsis evaluation — which was greater among patients with a previous history of sepsis (adjusted RR = 1.4; 95% CI, 1.2-1.5) — required respiratory support and intubation that also increased significantly in the postimmunization period.

Adverse events were similar across all vaccine types. Previous research suggested that DTaP vaccines are associated with an increase in adverse events such as apnea and bradycardia.

DeMeo and colleagues wrote that there is some evidence suggesting that ELBW infants who receive all three routine 2-month vaccines simultaneously have a higher risk for fever than those who are vaccinated during two or three administrations. The researchers said their study results, however, provide no basis to suggest that physicians should refrain from combination vaccines in ELBW infants. Instead, further studies are warranted to better understand the immunization process in this population and allow physicians to make more-informed decisions.

“Better knowledge of the risk factors for and timing of adverse events after immunization in extremely low birth weight infants could lead to better monitoring, prevent unnecessary sepsis evaluations and reduce immunization delay,” DeMeo and colleagues concluded. – by David Costill

Disclosure: DeMeo reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.