Immunizations and Your Preemie

August 25, 2014 my preemie turned 2 months old in the NICU, he was definitely in the home stretch. He had moved to the intermediate nursery, was “out of heat,” and in a regular crib. I thought his car seat test was next. But, what I was asked instead was, did I want him to get his 2-month immunizations. My happy heart deflated a bit and I whined said “But I thought you’d go by his adjusted just like most everything else.”

The nurse was quick to explain, “We follow the recommended immunization schedule according to actual age and not adjusted age.” Then, she went on to say how preemies especially need to receive their immunizations on time since their immune systems are put to the test much sooner than full-term babies. Also, they are more likely to develop disease-related complications if they get the disease that the shots are meant to prevent.

Initially, I had no idea why I reacted that way. My preemie had already received his first dose of the Hepatitis B vaccine after he was born at 29-weeks and in stable condition. I do remember feeling some hesitation back then when his nurse asked me if I wanted him to get it. But, with all that was going on at the time, I quickly glanced over the fact sheet she had given me about the vaccine and consented. It later dawned on me that my son’s early birth had prevented me from educating myself about immunizations. I was putting that off until later in my pregnancy, when I was just too pregnant to do much more than sit and read. That is why I had felt such hesitation.

However, after talking to the nurse some more, and after doing my own research, I learned that it is imperative to keep your children up-to-date on their immunizations. Therefore, I agreed to my son receiving his 2-month immunizations and continue to have him vaccinated based on the Recommended Immunization Schedule for Children (Birth-6 years old.)

According to the National Public Health Information Coalition (NPHIC), “vaccines give parents the safe, proven power to protect their children from 14 serious diseases before they turn 2 years old. Every dose of vaccine is important to protect against infectious diseases like the flu, measles, and whooping cough (pertussis) that can be life threatening for newborns and young babies. You can provide the best protection by following the recommended immunization schedule-giving your baby every vaccine she needs, when she needs it-and by making sure those who will be around your baby are vaccinated, too.”

If your preemie is still in the NICU, and you have questions or concerns about immunizations, the Division of Neonatology at Golisano Children’s Hospital, University of Rochester Medical Center, may have some answers for you on their website. Here is a sample of some of the important questions they have answered:

Are the shots safe for a premature baby?

Premature babies don’t have any more side effects from their shots than do babies who were born at full term. In fact, premature babies seem to have fewer fevers with their shots than full-term babies. Some premature babies will have more apnea and bradycardia (“A’s and B’s”) for about a day after the shots, but this gets better. We will wait to give the shots if we feel a baby is too sick. You can read more about the side effects of the individual shots in the vaccine information sheets you will be given.

Why not just wait until my baby is bigger?

Premature babies can get a lot sicker than full-term babies if they get the diseases that the shots prevent (especially pertussis). We need to make sure that premature babies get full protection as soon as possible.

Does my baby need to get a full dose of the shots?

Yes. Half or split doses of the shots don’t work as well. Even small premature babies need the full dose to get full protection.

The most important thing to note is: if you do have questions/concerns, the best person to ask is your child’s doctor!

For all parents, here is the 2014 Recommended Immunization Schedule for Children (Birth through 6 years old), courtesy of the Centers for Disease Control and Prevention (CDC):

Vaccines 2c


While there are no federal laws that require anyone to be vaccinated, all 50 states do require children entering daycare, public school and college to be vaccinated against certain diseases. The CDC has a searchable database where you can find the vaccination requirements for your state.

Although vaccinating your children is a personal choice, please keep in mind, when you choose to vaccinate your children, you are not only protecting them, you are also protecting the most vulnerable: our preemies.