Pinquier D, Adde-Michela C, Ploin D, Levêque C, Marret S
EA4309, Service de Pédiatrie Néonatale et Réanimation, Université de Rouen, CHU Charles-Nicolle, Institut Hospitalo-Universitaire de Recherche Biomédicale, 1 Rue Germont, 76031 Rouen Cedex, France.
Arch Pediatr. 2009 Dec;16(12):1533-9. doi: 10.1016/j.arcped.2009.09.009. Epub 2009 Oct 24.
There are few data examining the vaccine practices for 0- to 24-month-old premature infants born before 33 GW. The aim of the study was to examine the vaccine coverage in this population according to the French schedule at 6 and 24 months.
Eighty-seven infants were included in this regional prospective study. The immunization program began late and was initialized principally with DTPCoqHib (63%), usually after the 4th month. Fewer than one infant out of two (45%) had received three doses by 6 months of age. At 2 years of age, the coverage was 99% at 3 doses and decreased to 83% for 4 doses. For the MMR vaccine, the average age of administration was after 15 months, and 95% of infants had received one dose of MMR at 2 years of age. BCG coverage at 2 years of age was 94%, administered on average at 7 months. Forty-seven percent of the infants had received at least one dose of hepatitis B vaccine before 2 years of age, but only 31% had received two doses and a booster at 2 years of age. The adaptation of vaccination practices basically concerns the initial date of vaccination, but the immunization calendar is not recovered at 2 years of age. This should be taken into account for pertussis disease prevention in these young infants during the first 6 months of life, increasing the susceptibility period for this infectious disease.
The vaccine practices do not follow the postnatal chronological age of the premature baby according to the schedule recommended for full-term infants and vaccination is begun late. Based on the CSHPF vaccination recommendations, nearly 7 premature infants out of 10 have an incomplete immunization status for DTPCoqHib, hepatitis B, and ROR at 2 years of age. According to the pertussis coverage observed in premature infants, the new recommendations on vaccination of the newborn's care giver and family should be completed before the infant's discharge from the hospital using a new acellular vaccine for adult immunization. The initiation of an immunization program during hospitalization would be beneficial for premature babies still hospitalized after 2 months of age.
关于孕周小于33周出生的0至24个月早产婴儿的疫苗接种情况,相关数据较少。本研究旨在根据法国疫苗接种计划,调查该人群在6个月和24个月时的疫苗接种覆盖率。
本地区前瞻性研究纳入了87名婴儿。免疫接种计划开始较晚,主要从DTPCoqHib疫苗开始接种(63%),通常在出生后第4个月之后。在6个月龄时,不到一半(45%)的婴儿接种了3剂疫苗。在2岁时,3剂疫苗的接种覆盖率为99%,4剂疫苗的接种覆盖率降至83%。对于麻疹、腮腺炎和风疹(MMR)疫苗,平均接种年龄在15个月之后,95%的婴儿在2岁时接种了1剂MMR疫苗。2岁时卡介苗(BCG)接种覆盖率为94%,平均接种年龄在7个月。47%的婴儿在2岁前至少接种了1剂乙肝疫苗,但2岁时只有31%的婴儿接种了2剂并完成了加强免疫。疫苗接种实践的调整主要涉及疫苗接种的起始日期,但在2岁时免疫接种时间表仍未完善。在这些婴儿出生后的前6个月预防百日咳时应考虑到这一点,因为这会增加他们对这种传染病的易感性。
疫苗接种实践未按照足月儿推荐的时间表遵循早产婴儿的出生后实际年龄,接种开始较晚。根据加拿大儿科学会疫苗接种建议,近十分之七的早产婴儿在2岁时白喉、破伤风、无细胞百日咳、b型流感嗜血杆菌结合疫苗(DTPCoqHib)、乙肝疫苗和轮状病毒疫苗(ROR)的免疫接种状态不完整。根据早产婴儿中观察到的百日咳疫苗接种覆盖率,应在婴儿出院前,使用用于成人免疫的新型无细胞疫苗,完善关于新生儿护理人员和家庭成员疫苗接种的新建议。对于2个月龄后仍住院的早产婴儿,在住院期间启动免疫接种计划将有益处。