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The Problems with Vaccinating Premature Babies

The earlier in life that infants are vaccinated, the poorer and more short-lived their antibody responses are, irrespective of maternal antibody levels.’

Expert Rev Vaccines. June 2010; 9 (6): 665-674.

If you’d had a premature baby you might be feeling conflicted over whether you should vaccinate your baby. On one hand, a neonate doesn’t have his own immune system and is more prone to infections than an older child. For a pre-term infant, this risk is even higher. On the other hand, pre-term infants are not able to mount a sufficient response to vaccination and they are at greater risk of severe and life-threatening reactions after vaccination.

A Baby Doesn’t Produce His Own Antibodies Until Around 18 Months Old

When a baby is born, he recieves his immunity from his mother’s antibodies that are passed to him via the placenta. If he is born vaginally, his mother’s vaginal bacteria will also colonize his gut and activate his mucosal immune response. If he’s breastfed, he also recieves antibodies, anti-bacterial and anti-viral agents via the breast milk.

The baby’s own antibody system doesn’t develop until around 18 months. This is probably because the antibody response is an inflammatory response and since the baby is going through critical stages of development and rapid brain growth, any inflammation could be hazardous to this and potentially damaging to the baby’s neuro-developmental and physical function. To preserve vital functioning, the neonatal immune system is non-reactive and largely inherited from the mother.

In another area of medicine altogether – HIV testing – doctors know that they can’t antibody test a baby born to a HIV infected mother because the result will always be false positive. The baby carries mother’s antibodies to begin with and doesn’t replace them with his own until a year and a half:

‘Since newborns keep their mother’s antibodies until they produce their own antibodies at around 18 months of age, a positive neonatal HIV test result reveals the presence of maternal antibodies that indicate exposure to the virus, not necessarily infection by the virus. A baby born to an HIV-positive mother will thus always test positive for HIV, whether that newborn is truly seropositive ornot.’

American Medical Association, Virtual Mentor. December 2009, Volume 11, Number 12: 969-973.

http://virtualmentor.ama-assn.org/2009/12/hlaw1-0912.html

Further down in the same publication they stress the need for ‘immunisation’ in such infants when they already know a baby at birth, 2 months, 4 months, 6 months and one year doesn’t make his own antibodies – therefore, it is unsurprising that babies contract illnesses they have been vaccinated for multiple times over.

Expert Rev Vaccines writes:

‘Traditionally, studies of vaccine efficacy have relied upon measurements of vaccine-specific antibodies. However, maternally derived antibodies, transferred trans-placentally during gestation and in breast milk, may influence vaccine antibody responses in early life. Thus, the presence of maternal antibodies can inhibit the development of the infant humoral response to both live and killed vaccines, dependent on maternal-derived antibody levels at the time of vaccination….. Inhibition of measles vaccine by high-titer maternal antibody has been well documented and can last until the infant is up to 12 months of age, and this is why measles vaccination is generally deferred until 9–12 months of age (reviewed in [24]). It is thought that maternal antibodies neutralize live vaccines, thus limiting immune priming. However, these antibody–antigen complexes are still presented by DCs and induce T-cell-mediated responses which, in some cases, are enhanced [23]. Furthermore, it is not possible to distinguish maternal from infant IgG, limiting the usefulness of antibody assays in the assessment of vaccine-specific immunity in this age group.’

So, the normal way of assessing vaccine efficacy doesn’t apply in the first year of life at least because the antibodies present will be maternal. It’s not possible to identify the difference between maternal and infant immunoglobulin G (antibody) so the tests on vaccine derived immunity are useless.

 

The Earlier You Vaccinate, the Less They Work

Despite scientists knowing that young babies don’t make their own  IG G antibodies, they still test for these antibody levels to establish ‘immunity’.

Not surprisingly – they don’t get very good results.  Expert Rev Vaccines wrote:

‘The earlier in life that infants are vaccinated, the poorer and more short-lived their antibody responses are, irrespective of maternal antibody levels.’

So the rationale behind vaccinating premature infants at their chronological age instead of their gestational age and the rationale behind vaccinating any infant under 18 months is nonsense. Premature babies vulnerable to infection will not gain protection from these vaccines anyway.

Scientists are increasingly understanding that true immunity is not just a humoral response (based on antibody mediated immunity) but it also occurs on a cellular level. Despite this, they make a frank admission:

‘Despite this, good correlates of protective cellular immunity for most vaccine-preventable diseases have not been defined for adults or infants…..Our lack of understanding of how the infant immune system develops, and how the innate and adaptive arms of the immune system interface in early life presents a major hurdle.’

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937226/

Poor Antibody Responses to Vaccination in Premature Babies

Poor humoral immunity is elicited from vaccinations in premature babies (and remember, they can’t tell the difference between maternal IG G and infant IG G and they don’t really know what they’re testing on how the infant immune system works:

Effect of a fourth Haemophilus influenzae

type b immunisation in preterm infants who received dexamethasone for chronic lung disease

Published data indicate an impaired antibody response to pri-

mary immunisation with the conjugate Hib vaccines PRP-T
(polyribosylribitol phosphate-tetanus protein) and PRP-OMP
(polyribosylribitol phosphate-outer membrane protein of
meningococcus B), and with a newer combined Hib
vaccine.
5–9 Extreme prematurity below 30 weeks gestation cor-

relates with greater attenuation of antibody response.

Extreme prematurity and corticosteroid treatment appear
to be major factors attenuating antibody response to routine

Hib immunisation in infants born preterm.

This study sought to analyse the immune response of steroid treated

extremely preterm infants to an additional Hib vaccine dose….

There was no significant increase in antibody titre resulting

from the fourth Hib immunisation.

An additional Hib immunisation given to recently steroid treated preterm infants six weeks after completion of the primary schedule did not augment primary immunogenicity.’

Arch Dis Child Fetal Neonatal Ed 2003;88:F58–F61

http://fn.bmj.com/content/88/1/F58.full.pdf

Hepatitis B vaccination of premature infants: a reassessment of current recommendations for delayed immunization.

Source:

Pediatrics. 1999 Feb;103(2):E14

Hib vaccination in infants born prematurely

Interferon-γ –Receptor Deficiency in an Infant with Fatal Bacille Calmette–Guérin Infection

 

Source:

N Engl J Med 1996; 335:1956-1962December 26, 1996DOI: 10.1056/NEJM199612263352604.

Disseminated Mycobacterium bovis infection after BCG vaccination

Iran J Allergy Asthma Immunol. 2006 Sep;5(3):133-7.

BCG vaccine also caused retinal detachment in a premature baby who had had earlier successful laser treatment. The vaccine caused regression of changes to the retina:

The detachment of retina as possible complication after BCG vaccination during HOP–description of case.

 

Source: Klin Oczna. 2006;108(10-12):446-9.

Premature Infants are at Greater Risk of Serious Reactions to Vaccination

Source:

J. Pediatr. (Rio J.) vol.88 no.2 Porto Alegre Mar./Apr. 2012

Recurrent apnoea post immunisation: Informing re-immunisation policy.

Source: Vaccine. 2011 Aug 5;29(34):5681-7. doi: 10.1016/j.vaccine.2011.06.005. Epub 2011 Jun 20.

Frequency of apnea, bradycardia, and desaturations following first diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B immunization in hospitalized preterm infants.

Source: BMC Pediatr. 2006 Jun 19;6:20.

Apnoea and bradycardia in preterm infants following immunisation with pentavalent or hexavalent vaccines

 

Source: Eur J Pediatr. 2005 Jul;164(7):432-5. Epub 2005 Apr 21.

Positive Screening for Autism in Ex-preterm Infants: Prevalence and Risk Factors

 

Source: Pediatrics Vol. 121 No. 4 April 1, 2008 
pp. 758 -765 
(doi: 10.1542/peds.2007-2158

Evidence of Aluminium Loading in Infants Recieving Intravenous Therapy

http://www.nejm.org/doi/full/10.1056/NEJM198505233122101

 

Adverse Events After Routine Immunization of Extremely Low-Birth-Weight Infants

Source: JAMA Pediatrics,
August 2015, Vol 169, No. 8 >

Effect of thimerosal on the neurodevelopment of premature rats.

Source: World J Pediatr. 2013 Nov;9(4):356-60. doi: 10.1007/s12519-013-0443-z. Epub 2013 Nov 14.

http://www.ncbi.nlm.nih.gov/pubmed/24235069

Premature Twins Stop Breathing After Being Vaccinated

Source: BBC News, 1st September 2003.

http://news.bbc.co.uk/1/hi/england/northamptonshire/3198721.stm

Premature babies are at particular risk of neurodevelopmental disorder after vaccination

Source: Front. Public Health | doi: 10.3389/fpubh.2016.00270.