Insufficient immune protection in preterm infants due to delayed or incomplete hexavalent vaccination

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Publicado en:Frontiers in Immunology vol. 16 (Oct 2025), p. 1626057-1626068
Autor principal: Kaiser, Elisabeth
Otros Autores: Weber, Regine, Bous, Michelle, Fortmann, Ingmar, Dammann, Marie-Theres, Marißen, Janina, Viemann, Dorothee, Derouet, Christoph, Hein, Steve, Nourkami-Tutdibi, Nasenien, Tutdibi, Erol, Wuhrmann, Mara, Hans, Muriel Charlotte, Gille, Christian, Gehring, Stephan, Henneke, Philipp, Härtel, Christoph, Goedicke-Fritz, Sybelle, Zemlin, Michael
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022 |a 1664-3224 
024 7 |a 10.3389/fimmu.2025.1626057  |2 doi 
035 |a 3278324113 
045 2 |b d20251001  |b d20251031 
100 1 |a Kaiser, Elisabeth  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
245 1 |a Insufficient immune protection in preterm infants due to delayed or incomplete hexavalent vaccination 
260 |b Frontiers Media SA  |c Oct 2025 
513 |a Journal Article 
520 3 |a IntroductionFor preterm infants, a 3 + 1 schedule is recommended for hexavalent vaccinations during the first year. The aim of this study was to analyze completion and timeliness of vaccinations in preterm infants of 28 + 0 – 32 + 6 weeks of gestation as part of the PRIMAL study (PRiming of IMmunity At the beginning of Life) and the antibody responses to vaccination antigens.MethodsPlasma antibody-concentrations against poliomyelitis, Haemophilus influenzae type b (Hib), diphtheria and tetanus were determined using ELISA and evaluated with respect to their protectiveness.ResultsAmong 82 patients that were recruited, paired plasma samples on admission and at the one year follow up visit were available in 41 infants. In 17 infants, plasma samples were also collected at two months, prior to the first vaccination. Transplacental antibody transfer yielded protective antibody concentrations against the vaccine antigens in 66% (Hib) to 93% (tetanus) of the infants on admission and in 24% (Polio) to 50% (diphtheria) at 2 months. At the one-year follow-up, all infants who received their vaccinations on time had complete immune protection. However, after one year, hexavalent vaccination was incomplete in 30 of 41 infants (73%). Among incompletely vaccinated infants, the proportion lacking protective antibody concentrations ranged from 12% for diphtheria to 27% for polio.ConclusionsDue to insufficient adherence to vaccination recommendations, 42% of highly vulnerable preterm neonates were insufficiently protected against one or more vaccine-preventable diseases after one year. Efforts should be increased to improve adherence to the recommended 3 + 1 vaccination schedule in preterm infants. 
610 4 |a GraphPad Software 
651 4 |a Austria 
651 4 |a United States--US 
651 4 |a Massachusetts 
651 4 |a Germany 
653 |a Neonates 
653 |a Vaccines 
653 |a Plasma 
653 |a Diphtheria 
653 |a Infants 
653 |a Premature babies 
653 |a Poliomyelitis 
653 |a Ethics 
653 |a Performance evaluation 
653 |a Blood 
653 |a Consent 
653 |a Tetanus 
653 |a Immunity (Disease) 
653 |a Antigens 
653 |a Newborn babies 
653 |a Birth weight 
653 |a Gestational age 
700 1 |a Weber, Regine  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Bous, Michelle  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Fortmann, Ingmar  |u Department of Pediatrics, University Hospital of Lübeck, Lübeck, Germany 
700 1 |a Dammann, Marie-Theres  |u Department of Pediatrics, University Hospital of Lübeck, Lübeck, Germany 
700 1 |a Marißen, Janina  |u Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany 
700 1 |a Viemann, Dorothee  |u Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany 
700 1 |a Derouet, Christoph  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Hein, Steve  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Nourkami-Tutdibi, Nasenien  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Tutdibi, Erol  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Wuhrmann, Mara  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Hans, Muriel Charlotte  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Gille, Christian  |u Department of Neonatology, University of Heidelberg, Heidelberg, Germany 
700 1 |a Gehring, Stephan  |u Department of Pediatrics, University Medical Center Mainz, Mainz, Germany 
700 1 |a Henneke, Philipp  |u Department of Pediatrics, University of Freiburg, Freiburg, Germany 
700 1 |a Härtel, Christoph  |u Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany 
700 1 |a Goedicke-Fritz, Sybelle  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
700 1 |a Zemlin, Michael  |u Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany 
773 0 |t Frontiers in Immunology  |g vol. 16 (Oct 2025), p. 1626057-1626068 
786 0 |d ProQuest  |t Health & Medical Collection 
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856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3278324113/fulltext/embedded/75I98GEZK8WCJMPQ?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3278324113/fulltextPDF/embedded/75I98GEZK8WCJMPQ?source=fedsrch