Durham Reporter

Hospitalized premature infants who receive the recommended two-month vaccinations face an increased risk of brief apnea episodes, according to a study led by Duke Health researchers. The study, published in JAMA Pediatrics on January 6, reaffirms previous findings that link apnea, a temporary pause in breathing, to vaccinations among preterm babies. This potential side effect has been noted in earlier studies and is listed on vaccine package inserts.

"While there is a temporary increased risk of apnea after vaccination, the risk posed by vaccine-preventable respiratory and other infections to unvaccinated infants is far higher," stated Rachel G. Greenberg, M.D., lead author and associate professor at Duke University School of Medicine. Greenberg highlighted that hospitalized premature infants have weakened immune systems and existing conditions that heighten their vulnerability to severe illnesses such as pertussis and pneumonia.

Greenberg emphasized that the apnea episodes observed were brief and without serious complications. "As a result, our study supports that the current vaccination recommendations for premature infants are appropriate," she said. She also stressed the importance of educating parents about what to expect when their premature infants receive vaccines while hospitalized.

The study involved 223 hospitalized premature infants born before 33 weeks gestation. At two months old, about half were randomly assigned to receive childhood vaccines protecting against diseases like pneumonia, diphtheria, tetanus, pertussis, hepatitis B, polio, and meningitis. The remaining infants did not receive vaccines for two days but were allowed routine vaccinations afterward.

Infants were monitored for apnea for 48 hours post-vaccination or randomization for those unvaccinated. Those who received vaccines showed a higher likelihood of experiencing an apnea episode during this period compared to unvaccinated babies. The odds of an apnea episode were 2.7 times greater in the vaccinated group within the monitoring window.

Apnea episodes averaged 28 seconds in duration for vaccinated infants and 32 seconds for those unvaccinated. "The increased risk of brief apnea following vaccination must be weighed against the benefits of timely vaccination," the authors wrote. They pointed out that premature infants are more susceptible to vaccine-preventable diseases like pertussis (whooping cough) and invasive pneumococcal disease.

Besides Greenberg, co-authors include Wes Rountree, Mary Allen Staat, Elizabeth P. Schlaudecker, Brenda Poindexter, Andrea Trembath, Matthew Laughon, Marek S. Poniewierski, Rachel L. Spreng, Karen R. Broder, A. Patricia Wodi, Oidda Museru E., Gloria Anyalechi Paige L., Marquez Emily A., Randolph Samia Aleem Ryan Kilpatrick Emmanuel B., Walter.

The Centers for Disease Control and Prevention funded this research under contracts 200-2012-53663/0010 and 200-2012-53661/0007.