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August 2015

Differentiating Sepsis From Adverse Events After Immunization in the Neonatal Intensive Care Unit: How Is a Physician to Know?

Author Affiliations
  • 1Division of Research, Kaiser Permanente Northern California, Oakland
  • 2Division of Neonatology, Kaiser Permanente Northern California, Oakland
  • 3Division of Neonatology, University of California, San Francisco
  • 4Kaiser Permanente Vaccine Study Center, Oakland, California
JAMA Pediatr. 2015;169(8):718-719. doi:10.1001/jamapediatrics.2015.0759

In this issue of JAMA Pediatrics, DeMeo et al1 report on the incidence of adverse effects after immunization of extremely low-birth-weight (ELBW) infants in the neonatal intensive care unit (NICU). They report that there is an increase in the incidence of sepsis evaluations, respiratory support, and intubation after immunization.

The findings of this study confirm what a number of other retrospective studies have found—that ELBW infants appear to have an increase in cardiorespiratory events after vaccination. The main strength of this study and what makes it unique is its large sample size of infants born at less than 28 weeks’ gestation, including those born at the most premature ages (ie, gestational ages [GAs] of 23-24 weeks). This study’s large size further allowed evaluation of single antigen vs combination vaccines, with the authors concluding that there was no difference in the incidence of adverse events after varying vaccine types. This finding should provide some reassurances to neonatologists and parents.

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