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- Vaccines are safe for both premature and full-term infants.
- Premature and underweight infants are at a higher risk of developing complications from vaccine-preventable diseases if their vaccinations are delayed.
Rigorous testing procedures have made vaccines among the safest medicines administered to children and adults, but an Instagram post claims the risks far outweigh the benefits of immunizing a premature infant.
"Premature infants are at a much higher risk of injury from immunizations than full-term babies," the Oct. 10 post claims. "Despite the data showing just how dangerous it is, medical professionals still pressure parents to comply with the regular schedule."
The post features a series of text slides detailing the supposed risks that premature and underweight infants are more susceptible to if they get immunized, including apnea, bradycardia and sepsis. The final side includes links to three studies examining suspected negative reactions that premature and underweight infants had to vaccinations.
The post was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Meta, which owns Facebook and Instagram.)
None of the three studies cited advocated against vaccinations for premature and underweight infants.
One of the studies concluded that the risk of an underweight infant — a category that often includes premature babies — developing severe side effects following vaccination was small.
The first study cited was published in 1997 and examined the incidence and severity of apnea, which is when a person briefly stops breathing, typically while asleep; and bradycardia, a too-slow heart rate. The study looked at 98 premature infants born in Australia who received the DTwP vaccine to protect against diphtheria, tetanus and whooping cough.
The study observed that 17 infants developed apnea and/or bradycardia after immunization. Of the 17, 12 infants experienced "brief, self-limiting" issues, while two were given supplemental oxygen. The study did not advocate against vaccinations.
However, the study is now based on out-of-date information because the DTwP vaccine is no longer used by many developed nations, including Australia and the United States. It has since been replaced by the DTap vaccine, which has fewer reported side effects.
The second study cited by the Instagram post was published in 2016 and examined reported side effects following immunizations with single-dose and combination vaccines in 13,926 premature infants with extremely low birth weights in neonatal intensive care units.
The study found that the babies experienced an increase in severe side effects following vaccinations, such as breathing issues requiring extra respiratory support like intubation or a ventilator.
The need for respiratory support jumped from 6.6 per 1,000 patient days before vaccination to 14 per 1,000 patient days afterwards. Patient days measures the amount of time someone remains hospitalized.
But the study did not recommend against vaccinations. Conversely, it concluded that delaying vaccines for underweight infants could prove dangerous.
"Immunization delay burdens an already fragile patient population with the increased morbidity and mortality of vaccine-preventable diseases through the first year of life," it said.
The third study cited was published in 2011 and also looked at infant birth weight and how it might relate to side effects from vaccinations. It primarily examined emergency room visits and hospital admissions that occurred following vaccinations.
"Lower birth weight appears to be correlated with an increased risk of emergency room visits within 24 hours of vaccination," it said. "The absolute risk (from vaccinations) is small, and there was no impact on (hospital) admissions or death."
The current recommendation from the Centers for Disease Control and Prevention is to vaccinate premature infants who were born before 37 weeks of gestation "regardless of birth weight," using the same immunization schedule as that of a full-term baby.
"Birth weight and size are not factors in deciding whether to vaccinate a clinically stable preterm infant, except for hepatitis B vaccination," the CDC said. "The full recommended dose of each vaccine should be used. Divided or reduced doses are not recommended."
The hepatitis B vaccine is the only vaccination a newborn infant receives at birth, but the CDC said it’s less effective in those born prematurely. The CDC's guidance for giving the hepatitis B vaccine to premature infants varies depending on whether the mother is positive for the virus.
The immunization schedule recommends infants begin the first vaccine doses when they reach 2 months of age.
The American Academy of Pediatrics found that premature and underweight infants still benefit from receiving the same vaccines as full-term infants and that they are safe to use. Any potential side effects from a vaccine would be the same, regardless if an infant was premature.
An Instagram post claims premature infants are at a higher risk of injury from vaccinations compared with full-term babies.
The post misleads on the findings of three studies it cites. One of the studies is outdated, as it was based on observations of a vaccine no longer widely used in developed nations, including the United States.
Another study found that premature, underweight infants have a higher risk of experiencing side effects following vaccinations. But the study also cautioned that underweight infants risked being infected with a vaccine-preventable disease if left unvaccinated for too long.
The third study only looked at hospital and ER admission rates between premature and full-term infants following their vaccinations, not side effects. It found that vaccinations did not affect hospital admissions.
None of the studies recommended against vaccinating or delaying vaccinations for premature and underweight infants. Medical professionals say vaccines are safe to use in premature infants and should be administered according to the same immunization schedule as full-term babies.
We rate this claim False.
Journal of Paediatrics and Child Health, "Incidence of apnoea and bradycardia in preterm infants following DTPw and Hib immunization: a prospective study," October 1997
UpToDate, "Diphtheria, tetanus, and pertussis immunization in children 6 weeks through 6 years of age," Feb. 22, 2022
JAMA Pediatrics, "Adverse Events After Routine Immunization of Extremely Low Birth Weight Infants," August 2015
CDC, Vaccines Recommendations and Guidelines of the ACIP, July 12, 2022
CDC, Child & Adolescent Immunization Schedule, Feb. 17, 2022
American Academy of Pediatrics, "Immunization of Preterm and Low Birth Weight Infants," July 1, 2003
American Academy of Pediatrics, Immunizations for preterm babies, Aug. 23, 2017
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