IMMUNISATION IN PREMATURE BABIES

• If the premature baby is healthy, he/she should receive all vaccines (except Hepatitis B vaccine) as per the recommended schedule of immunization for that country. This is done according to the chronological age after birth and not the post conceptional age.
• If the premature baby is < 2 kg, he/she should be given all the vaccines at the time of discharge, which are normally recommended at birth.
• Hepatitis B vaccine deserves a special mention;
• If the weight of the baby is < 2 kg and mother is HBsAg negative, then Hepatitis B vaccine is postponed till the baby attains a weight of 2 kg. or 2 months of age.
• However, if the mother is HBsAg positive, then both Hepatitis B vaccine and Hepatitis B immunoglobulin (if available and affordable) is administered within 12 hours of birth followed by 3 more doses at 1, 2 and 6-12 months.
• For preterm and low birth weight babies born to HBsAg positive mothers, a 4 dose schedule at 0,1,2 and 12 months is preferable.