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Vaccinations and Neonatal Immunity

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Neonatology

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Abstract

Immune responsiveness quickly matures in both term and preterm neonates after birth, rapidly reaching levels comparable with those observed in children and adults. The duration of this maturation process is variable and also depends on the type of antigen to which immunity is directed. Maternally acquired passive immunity keeps a major protective role during the first months of life, via transplacentally acquired IgG and maternal IgA acquired via breast milk. The safety profile and immunogenicity of routinely administered vaccines are similar in premature neonates to those measured in full-term infants. Preterm and low birth weight infants should be immunized according to their chronological age. Indeed, early and timely immunization of preterm and low birth weight infants is safe and essential for protecting them against diseases to which these infants are particularly susceptible and that may be even fatal. Besides traditional vaccination, maternal immunization during pregnancy is being tested and it is proving quite effective; new vaccines are therefore being studied in pregnant women. A potential cause of concern is whether vaccines administered to preterm infants induce a good immunological memory, because very preterm infants may develop a weaker immunological long-term response. Another critical aspect regarding neonatal vaccinations is the use of corticosteroids (often used in NICU) since they may decrease the response. In spite of that, their administration should not delay the vaccine schedule. The benefits of early and timely immunization of fragile children far exceed the risk of inducing suboptimal protection.

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Authors and Affiliations

  1. Institute of Child and Adolescent Health, Bambino Gesù Children’s Hospital, Rome, Italy

    Alberto G. Ugazio

  2. Multifactorial and Complex Diseases Research Area, Bambino Gesù Children’s Hospital, Rome, Italy

    Alberto E. Tozzi

Authors
  1. Alberto G. Ugazio
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  2. Alberto E. Tozzi
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Correspondence to Alberto G. Ugazio .

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Editors and Affiliations

  1. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Giuseppe Buonocore

  2. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Rodolfo Bracci

  3. Liverpool Women’s Hospital Neonatal Unit, Liverpool, UK

    Michael Weindling

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Ugazio, A.G., Tozzi, A.E. (2018). Vaccinations and Neonatal Immunity. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-29489-6_257

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  • DOI: https://doi.org/10.1007/978-3-319-29489-6_257

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