University of Hull, Hull, UK.
J Clin Nurs. 2017 Dec;26(23-24):4094-4104. doi: 10.1111/jocn.13916. Epub 2017 Aug 6.
To take a systematic approach to reviewing the scientific literature examining the timeliness of vaccination in preterm infants and to identify any factors associated with timeliness.
Preterm infants are vulnerable to infection and guidance advocates they are vaccinated in accordance with their full-term peers. Vaccination is well tolerated and protective immune responses are observed, yet some early enquiries suggest that preterm infants experience unwarranted delays. The recent surge in pertussis cases and the increase in vaccinations administered make this a topic requiring further exploration.
An integrative review of the empirical literature.
Studies were identified following a search of Medline, Academic Search Premier, Cochrane Database of Systematic Reviews and the Cumulative Index to Nursing and Allied Health Literature. The review methods used were influenced by a narrative synthesis approach. The retrieval of papers adhered to recognised reporting standards.
Fourteen studies were identified, which indicated that infants with the lowest gestational ages and birthweights experience the greatest delays. Vaccination timeliness is influenced by hospitalisation and increased postdischarge follow-up. There was a lack of consensus to indicate that parental socio-economic status and level of education were indicators for a delay. The studies propose that many delays are unjustified and not according to genuine contraindications.
This review indicates that preterm infants are not vaccinated in a timely manner. Those involved in vaccinating preterm infants must be informed of the genuine contraindications to avoid unnecessary delays putting preterm infants at an increased risk of infection.
Care providers should acknowledge the risk of a delay in preterm infants and actively promote vaccination in this population. Regular training should help to negate the occurrence of inappropriate delays, and careful discharge planning is needed to ensure that preterm infants are vaccinated on time.
采用系统方法回顾检查早产儿疫苗接种及时性的科学文献，并确定与及时性相关的任何因素。
早产儿易感染，指南建议他们按照足月婴儿的标准接种疫苗。疫苗接种耐受良好，可观察到保护性免疫反应，但一些早期研究表明，早产儿会出现不必要的延迟。最近百日咳病例的激增和接种疫苗数量的增加使得这一话题需要进一步探讨。
对经验文献进行综合回顾。
在 Medline、Academic Search Premier、Cochrane 系统评价数据库和 Cumulative Index to Nursing and Allied Health Literature 中搜索后，确定了研究。综述方法受叙述性综合方法的影响。论文检索符合公认的报告标准。
确定了 14 项研究，表明胎龄和出生体重最低的婴儿延迟时间最长。疫苗接种及时性受住院和增加的出院后随访影响。缺乏共识表明父母的社会经济地位和教育水平是延迟的指标。这些研究表明，许多延迟是不合理的，且不是由于真正的禁忌症。
本综述表明早产儿未及时接种疫苗。接种早产儿疫苗的人员必须了解真正的禁忌症，以避免不必要的延迟，使早产儿面临更大的感染风险。
护理人员应认识到早产儿延迟接种的风险，并积极在该人群中推广疫苗接种。定期培训有助于消除不适当的延迟，需要仔细制定出院计划以确保早产儿按时接种疫苗。
