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Preterm babies  - p 55. Australian Immunisation Handbook, 8th Edition - 9/2003

Despite their immunological immaturity, preterm babies should be vaccinated according to the recommended schedule at the usual chronological age, provided that they are well and that there are no contraindications to vaccination. OPV, which might spread the live vaccine virus to other babies in the hospital, should not be given until the time of discharge. Alternatively, IPV (inactivated polio vaccine) can be used.

Preterm infants have a special need for protection and they have adequate antibody responses to most antigens. However, some smaller preterm babies do not respond as well as term babies to PRP-OMP Hib (PedvaxHIB) and hepatitis B vaccines 8-13 When PedvaxHIB is used in an extremely preterm baby (<28 weeks gestation or <1500 g birth weight), an additional dose of vaccine should be given at 6 months of age (ie. doses should be given at 2, 4, 6 and 12 months of age). Recommendations for hepatitis B vaccination of babies less than 32 weeks' gestation are described in Part 3.9, ‘Hepatitis B’, page 96.

All preterm babies born at less than 28 weeks’ gestation or with chronic lung disease should be offered the 7-valent pneumococcal conjugate vaccine at 2, 4 and 6 months of age with a fourth dose at 12 months of age, and a 23-valent pneumococcal polysaccharide vaccine booster at 4 to 5 years of age (see also Part 3.18, ‘Pneumococcal infections’).