[Active and passive immunization in the extremely preterm infant].
OBJECTIVE
A review of the indications, contraindications, ideal timing, immunogenic efficacy and reactogenicity (adverse events) of active and passive immunization for extremely preterm infants.


METHODS
Research in classic textbooks on pediatric infectology and in the electronic databases MEDLINE, Lilacs, PubMed and Akwanmed, using the following health sciences descriptors: premature, very low weight newborn, immunization, active immunization, passive immunization, vaccines, immunoglobulin.


RESULTS
The immunization of extremely premature very low birth weight infants is a huge challenge for pediatricians because there is insufficient knowledge about the efficacy of immune responses and undesirable reactions. Possibly for this reason, it is common that such children are found to be behind schedule with their immunizations or to have been incompletely immunized. Notwithstanding the scarcity of publications on the theme, in principal young gestational age and low birth weight should not be considered limiting factors to clinically stable premature newborns being immunized at the same chronological age indicated for full term children.


CONCLUSIONS
Based on the available evidence it not possible to propose vaccine and immunoglobulin administration practice for extremely premature or very low weight newborn babies that is definitive. With rare exceptions however, such as the BCG vaccine, the tendency is to maintain the same active immunization program as for babies born full term, irrespective of weight or gestational age at birth. Passive immunization merits special attention, having more liberal indications in this group of newborn babies.
Tavares
Eduardo C
EC
Dep. de Pediatria, Facudade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG. etavares@medicina.ufmg.br
Ribeiro
José Geraldo
JG
Oliveira
Lorenza A
LA
D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage; D007231:Infant, Newborn; D007234:Infant, Premature / Q000276:immunology*; D019102:Infant, Very Low Birth Weight / Q000276:immunology*; D014611:Vaccination; D014612:Vaccines / Q000008:administration & dosage
D007136:Immunoglobulins; D014612:Vaccines