A new study published in the Journal of the American Medical Association (JAMA) Pediatrics provides evidence that extremely low birth weight (ELBW) infants run a higher risk of suffering from adverse events such as fever, breathing problems (apnea), abnormally slow heart rates (bradycardia), and fever soon after being vaccinated. An even more serious and potentially deadly complication detected was sepsis, which is an overwhelming immune response to a bacterial infection that can cause organ failure. According to the research, these complications “present a diagnostic dilemma for physicians” which could potentially lead to delaying vaccinations.
The cohort study was conducted in 348 neonatal intensive care units (NICUs) managed by the Pediatrix Medical Group, Inc, an operating unit of MEDNAX Services, Inc. of Sunrise FL. Principal investigators were Stephen D. DeMeo, DO; Sudha R. Raman, PhD; Christoph P. Hornik, MD, MPH; Catherine C. Wilson, DNP, NNP-BC, FNP-BC; Reese Clark, MD; and P. Brian Smith, MD, MPH, MHS. They looked at the records of 13,926 extremely low birth weight babies in neonatal intensive care units (NICUs) and compared the incidence among them of life-threatening complications from infection (sepsis) that occurred three days prior to and three days after vaccination.
The researchers found an increased incidence of sepsis evaluations from 5.4 per 1,000 patient-days before vaccination to 19.3 per 1,000 patient-days after vaccinations. They observed an increased need for more respiratory support for the infants from 6.6 per 1,000 patient-days prior to vaccination to 14 per 1,000 patient-days after vaccination. The need for intubation (insertion of a tube into the windpipe to keep it open so the infant can breathe) also increased from 2 per 1,000 patient-days before vaccination to 3.6 per 1,000 patient-days after vaccination.
The nearly 14,000 ELBW infants studied had received a total of 48,853 vaccinations and 91.2% (12,703) of them had been given three or more vaccinations after birth despite their extremely low birth weight of less than 2.2 pounds. According to the study authors, five of the babies died within three days of being vaccinated. Of the three dead children, one had a bowel perforation, one had necrotizing enterocolitis and presumed sepsis, and one had pneumonia and respiratory failure.
In their conclusions, the authors of the study wrote, “Our findings provide no evidence to suggest that physicians should not use combination vaccines in ELBW infants. Further studies are needed to determine whether timing or spacing of immunization administrations confers risk for the developing adverse events and whether a prior history of sepsis confers risk for an altered immune response in ELBW infants.”
Read the study “Adverse Events After Routine Immunization of Extremely Low-Birth-Weight Infants” in the June 2015 issue of JAMA Pediatrics.