Roper J, Day S
Department of Clinical Epidermiology, London Hospital Medical College.
Arch Dis Child. 1988 May;63(5):518-21. doi: 10.1136/adc.63.5.518.
The timing of immunisations for preterm infants is controversial. Because of the statement by the British Paediatric Association/Joint Committee on Vaccination and Immunisation Liaison group that immunisations should normally begin three months after the date of birth, the records of all infants born in 1984 and currently (June 1986) resident in the London Borough of Newham were studied to find out if this recommendation was being implemented. Subjects were divided into groups by birth weight and where possible by gestational age. Cumulative uptakes by age of any component of the first and third triple immunisations, and of the pertussis component, were plotted separately. Comparison of uptake of the first course showed a considerable initial delay for infants weighing less than 2000 g at birth compared with heavier babies, but by 18 months the coverage was almost identical. This difference was not evident for the third course. A similar delay was apparent when infants of 37 weeks' gestation or less were compared with babies born at full term, though recording of gestational age was incomplete. Final overall uptake was poor for all groups. Differences among groups in numbers consenting were not an important factor. Informing those responsible for giving the immunisations of these findings has stimulated their interest in improving practice by implementing the recommendations.
早产儿免疫接种的时间安排存在争议。由于英国儿科学会/疫苗接种与免疫联合委员会联络小组声明免疫接种通常应在出生之日起三个月后开始，因此对1984年出生且目前（1986年6月）居住在纽汉姆伦敦自治市的所有婴儿的记录进行了研究，以了解这一建议是否得到实施。根据出生体重并尽可能按胎龄将研究对象分组。分别绘制了首次和第三次三联免疫接种的任何组成部分以及百日咳组成部分按年龄的累积接种率。首次接种的情况比较显示，出生时体重不足2000克的婴儿与体重较重的婴儿相比，初始延迟相当明显，但到18个月时，覆盖率几乎相同。第三次接种时这种差异不明显。将妊娠37周或以下的婴儿与足月出生的婴儿进行比较时，也出现了类似的延迟，尽管胎龄记录不完整。所有组的最终总体接种率都很低。各组同意接种的人数差异不是一个重要因素。将这些研究结果告知负责进行免疫接种的人员，激发了他们通过实施这些建议来改进做法的兴趣。
