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Underimmunization of very low birth weight infants at discharge from the neonatal intensive care unit

Journal of Perinatology volume 44, pages 55–61 (2024)Cite this article

Subjects

Abstract

Objective

To quantify immunization status among premature infants discharged from neonatal intensive care units (NICUs), and identify risk factors for underimmunization.

Study design

We performed a cohort study of infants <33 weeks gestation discharged home between 2011 and 2020 from 241 NICUs. Using multivariable logistic regression, we examined the association between risk factors and underimmunization at discharge, defined as <1 dose of 5 vaccine types when discharged at 60–119 days of age and <2 doses when discharged at 120–179 days of age.

Results

Of 30,766 infants discharged at 60–119 days of age, 14% were underimmunized. Among 4358 infants discharged at 120–179 days of age, 53% were underimmunized. For infants discharged at 60–119 days of age, ventilator support within 30 days of discharge was associated with underimmunization. Having a surgical procedure was associated with underimmunization in both groups.

Conclusion

A large proportion of premature infants discharged from the NICU are underimmunized.

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Fig. 1: Percentage of infants underimmunized by site (including sites with >10 infants) at discharge.
Fig. 2: Percentage of infants underimmunized at discharge by discharge year.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. North Carolina School of Science and Mathematics, Durham, NC, USA

    Veronica Quiett

  2. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA

    Elizabeth Thompson & Sudha R. Raman

  3. WakeMed Hospitals and Health System, Raleigh, NC, USA

    Stephen D. DeMeo

  4. Department of Pediatrics, Duke University Medical Center, Durham, NC, USA

    Christoph P. Hornik, Kanecia O. Zimmerman, P. Brian Smith & Rachel G. Greenberg

  5. Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA

    Reese Clark

Authors
  1. Veronica Quiett
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  2. Elizabeth Thompson
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  3. Sudha R. Raman
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  4. Stephen D. DeMeo
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  5. Christoph P. Hornik
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  6. Reese Clark
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  7. Kanecia O. Zimmerman
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  8. P. Brian Smith
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  9. Rachel G. Greenberg
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Contributions

ET and RGG had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: SRR, SDD, CPH, PBS, RGG. Acquisition, analysis, or interpretation of data: PBS, RGG, VQ. Drafting of the manuscript: VQ, SRR. Critical revision of the manuscript for important intellectual content: SDD, CPH, RC, PBS, RGG, ET. Statistical analysis: ET, RGG.

Corresponding author

Correspondence to Rachel G. Greenberg.

Ethics declarations

Competing interests

ET was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number T32GM086330 and the Eunice Kennedy Shriver National Institute of Child Health & Human Development under Award Number T32HD104576. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. PBS receives salary support for research from the NIH and the National Center for Advancing Translational Sciences of the NIH (HHSN267200700051C, HHSN275201000003I, and UL1TR001117). RGG has received support from industry for research services (https://dcri.org/about-us/conflict-of-interest/).

Ethics approval

The Duke University School of Medicine Institutional Review Board approved this study as exempt research. This study was performed in accordance with the Declaration of Helsinki.

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Quiett, V., Thompson, E., Raman, S.R. et al. Underimmunization of very low birth weight infants at discharge from the neonatal intensive care unit. J Perinatol 44, 55–61 (2024). https://doi.org/10.1038/s41372-023-01806-1

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