Vaccinations and Your Preemie

April 24, 2015
Preemie Vaccinations


Childhood vaccinations are often a hot topic these days, but so much of the discussion is about immunizing healthy, full-term babies. Is the conversation any different when it involves preemies?

When my 26-weeker hit the 2-month mark, he was still hospitalized, and vaccinations were the furthest thing from my mind. I was in the here-and-now of oxygen saturation and bradys, and in my mind vaccinations were for healthy babies living outside hospital walls. They weren’t even on my radar when the nurses began to discuss J’s first vaccinations with us.

Our NICU strongly encouraged immunizations. The neonatologists told us that with our son’s weakened lungs and immature immune system, it was crucial that he receive his vaccinations on the very same schedule as full-term babies. My friend’s 7-lb baby was born just five days before our tiny 2-lb baby; at two months old my son didn’t even weigh five pounds. I had trouble imagining them getting shots at the same time, but J had no issues at all. He didn’t even run a low-grade fever.

When my daughter turned two months old during her NICU stay, she was even smaller than J. She was having so much discomfort surrounding eating and diaper rashes (she had a milk protein allergy as it turns out) that I hated to add to her discomfort. The nurse suggested that if I had any misgivings about vaccinating her, or sticking her multiple times on one day, that we could spread her shots over a few days. She also reminded us that should M be a rare case and have a reaction, she would be hospitalized for her first vaccinations, which should be reassuring if you’re a NICU parent worried about giving shots to a tiny baby.

If your baby’s doctors say that your preemie is healthy enough for vaccinations (and most are), keep in mind that preventing serious childhood illnesses are most intended for our children with compromised immune systems. My son completely skipped the third trimester, when the immune system is fine-tuned, and he lost precious months building his immune system. Vaccinations are one way to protect tiny bodies from big illnesses that come with serious complications.

Preemies usually receive all the same vaccinations on the same schedule as full-term babies, which is an exception to the general rule that we adjust their developmental schedules to their due dates. The reason is that if a 30-weeker isn’t given vaccinations until she is 4 months old, instead of 2 months old, she is vulnerable for that many more months. One exception is the rotavirus vaccine. Unlike most infant immunizations, it is a live-virus vaccine given as a liquid rather than as a shot. The schedule for giving it is strict. If preemies aren’t able to receive it within the correct parameters, doctors sometimes skip it. Our son was hospitalized during the 6-to-14 week window when babies receive the first dose. The NICU didn’t give it to him, so he didn’t get any of the rotavirus vaccinations.

As we prepared to bring our babies home from the NICU, we were also concerned about necessary vaccinations for the caregivers of our babies. Most adults need a booster of Tdap, which prevents tetanus, diphtheria, and pertussis. A very real threat to a baby born early is pertussis, or whooping cough, and caregivers can transmit it without being sick themselves. Another consideration is having all caregivers get a flu shot during cold and flu season because preemies have a higher risk of developing pneumonia and other complications.

Make sure to discuss your baby’s health with your neonatologists and pediatricians. They will be able to advise you concerning your specific situation and give you further recommendations.

A recommended vaccination schedule for all kids is available on the CDC’s website. For more information about childhood vaccinations, go to the FDA’s website.