Vaccination in preterm and low birth weight infants in India

ABSTRACT

In India, the high neonatal and infant mortality rate is due in part to an increasing number of preterm and low birth weight (LBW) infants. Given the immaturity of immune system, these infants are at an increased risk of hospitalization and mortality from vaccine-preventable diseases (VPDs). In this narrative review, we screened the scientific literature for data on the risk of VPDs, vaccination delay and factors related to it in Indian preterm and LBW infants. Although routine childhood vaccinations are recommended regardless of gestational age or birth weight, vaccination is often delayed. It exposes these infants to a higher risk of infections, their associated complications, and death. After-birth complications, lack of awareness of recommendations, vaccine efficacy and effectiveness and concerns related to safety are some of the common barriers to vaccination. Awareness campaigns might help substantiate the need for (and value of) vaccination in preterm and LBW infants.

PLAIN LANGUAGE SUMMARY

What is the context?

• In India, the high neonatal mortality rate is due in part to an increasing number of pretern and low birth weight intants.

• Affected infants have a poorly developed inmune system and are more susceptible to contracting vaccine-preventable diseases.

• The Indian Academy of Pediatrics recommends vaccination according to the same schedule used for full term infants, following chronological (not gestational) age.

• Delays in vaccinations increase the risk of preventable infections.

What is new?

• Our review of the scientific literature shows that, in India:

  • infections have more serious conseuences in preterm and low birth weight infants

  • delays to vaccinate affected infants are common, mostly due to safety and effectiveness concerns from parents and healthcare pracitionrs.

What is the impact?

• Improving mternal nutritional status and immunization, and perinatal care could help reduce the number of preterm and low birth weight infants.

• Combining maternal immunization with vaccination of affected infants can confer safe and effective protection.

• Awareness campaigns for parents and healthcare practitioners could address the issue of vaccination delay in pretern and low birth weight infants in India.

KEYWORDS:

• Neonatal
• preterm
• low birth weight
• immunization
• India
• prematurity
• infectious disease
• vaccination

Acknowledgments

The authors thank Business & Decision Life Sciences platform for editorial assistance and manuscript coordination, on behalf of GSK. Benjamin Lemaire coordinated the manuscript development and editorial support. Amrita Ostawal (Arete Communication UG) provided medical writing support.

Disclosure of potential conflicts of interest

Santosh Soans declares no financial and non-financial relationships and activities and no conflicts of interest. Attila Mihalyi, Valerie Berlaimont and Shafi Kolhapure are employees of the GSK group of companies, hold shares in the GSK group of companies and declare no other financial and non-financial relationships and activities. Resham Dash and Ashish Agrawal are employees of the GSK group of companies and declare no non-financial conflicts of interest.

Contributorship

All authors participated in the design of this narrative review, interpretation of the results; and the development of this manuscript. All authors had full access to the data and gave final approval before submission.

Additional information

Funding

GlaxoSmithKline Biologicals SA took in charge all costs associated with the development and publication of this manuscript.