Apnea after immunization of preterm infants.
“However, 12 (12%) infants experienced a recurrence of apnea, and 11 (11%) had at least a 50% increase in the number of apneic and bradycardic episodes in the 72 hours after immunization.”
Adverse events following vaccination in premature infants.
“Apparent adverse events were noted in 17 of 45 (37.8%) babies: 9 (20%) had major events, i.e. apnoea, bradycardia or desaturations, and 8 (17.8%) had minor events, i.e. increased oxygen requirements, temperature instability, poor handling and feed intolerance. Babies with major events were significantly younger (p < 0.05), had a lower postmenstrual age (p < 0.05) and weighed less (p < 0.05) at the time of vaccination compared with babies without major events." "CONCLUSION: Vaccine-related cardiorespiratory events are relatively common in preterm babies. Problems were much more common if vaccine is administered at or before 70 d. These babies should therefore be monitored postvaccination." #Premature #Cardiorespiratory #Near #Miss #DTP #Hib #Bradycardia #Apnea #Respiratory #Cardiovascular #Vaccine #MedScienceResearch https://www.ncbi.nlm.nih.gov/m/pubmed/11529542
? [Cardiorespiratory events after first immunization in premature infants: a prospective cohort study].
“OBJECTIVE: To investigate whether all preterm infants born before 33 weeks of gestation need cardiorespiratory monitoring due to the risk of cardiorespiratory disturbances following their first vaccination at 2 months of age.”
“In this cohort of 41 premature infants whose mean gestational age was 30.8 weeks (SD: 1.9), 10 of these had a mild decrease in oxygen saturation or bradycardia; three developed a moderate cardiorespiratory event requiring tactile stimulation.”
“It is recommended that still-hospitalized premature infants receive their first immunizations under cardiorespiratory monitoring, as events were observed during a period of 0-24 hours thereafter.”
Incidence of apnoea and bradycardia in preterm infants following triple antigen immunization.
“Ninety-seven preterm infants were immunized with diphtheria-tetanus-pertussis (DTP) prior to discharge from hospital. The mean gestational age at birth was 28.1 weeks (range 24-34) and the mean age at immunization was 80.6 days (range 44-257). Nineteen (20%) infants developed apnoea or bradycardia within 24 h of immunization. The infants who developed apnoea and/or bradycardia had a younger gestational age at birth than those who did not (P = 0.03), were artificially ventilated for longer (P = 0.01) and were more likely to have a diagnosis of chronic lung disease (P = 0.006). In the majority of infants these events were not clinically significant. Two infants who developed concurrent upper respiratory tract infections required additional oxygen and one of them was treated with oral theophylline. In general, it is safe practice to immunize preterm infants with DTP unless otherwise contraindicated. However, it is recommended that cardiorespiratory function is monitored after immunization in very preterm infants who had prolonged ventilatory support and/or chronic lung disease.”
Possible predictors of cardiorespiratory events after immunization in preterm neonates.
“Immunization was performed on 31 very preterm infants [28 weeks’ gestation (26.9-29), birth weight: 965 g (795-1,105)], and was associated with an increased incidence (p < 0.01) of events lasting more than 10 s: bradycardia <80 bpm [2.2 (1.1-7) vs. 1.8 (1-4)/12 h], desaturation [17.6 (9.4-36.4) vs. 13.9 (7.7-33.8)/12 h] and associated bradycardia-desaturation [IB+D, 4.1 (1.4-7.3) vs. 2.4 (1-4.6)/12 h], with mild changes in HRV and no change in RRV." "The increase in CR events after the first immunization in very preterm infants was associated with: (1) sympathetic predominance in heart rate control (high LF/HF ratio), (2) abnormal oversimplification of HRV (low entropy) and (3) persistent respiratory rhythm control immaturity (high IB+D before vaccine)." #Cardiorespiratory #Premature #Respiratory #Bradycardia #Cardiovascular #Vaccine #MedScienceResearch https://www.ncbi.nlm.nih.gov/m/pubmed/23887711/
Recurrence of cardiorespiratory events following repeat DTaP-based combined immunization in very low birth weight premature infants.
“We evaluated the tolerance to immunization of 64 very low birth weight preterm infants. Thirty-three of the infants experienced a cardiorespiratory event after the first vaccination, and 6 of these 33 (18%) had a recurrence after the second vaccination, including 2 infants previously discharged to home. A cardiorespiratory event associated with the first vaccination was the sole risk factor for recurrence identified.”
Vaccination of preterm infants by polyvalent vaccines: immunogenicity and safety- review of literature.
“In order to reduce the risk of adverse events after the administration of a polyvalent vaccine, it is essential to carefully consider the cardiorespiratory status of preterm infants during preimmunization examination, as well as their history of any cardiorespiratory dysfunctions. In such cases administering the first dose of the vaccine in a hospital setting is strongly advised.”