Primary Immunization of Premature Infants with Gestational Age <35 Weeks

Cardiorespiratory Complications and C-Reactive Protein Responses Associated with Administration of Single and Multiple Separate Vaccines Simultaneously

Massroor Pourcyrous, Sheldon B. Korones, Kristopher L. Arheart, Henrietta S. Bada

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective: To determine the incidence of cardiorespiratory events and abnormal C-reactive protein (CRP) level associated with administration of a single vaccine or multiple separate vaccines simultaneously. Study design: Prospective observational study on 239 preterm infants at ≥2 months of age in the neonatal intensive care unit (NICU). Each infant received either a single vaccine or multiple vaccines on one day. CRP levels and cardiorespiratory manifestations were monitored for 3 days following immunization. Results: Abnormal elevation of CRP level occurred in 85% of infants administered multiple vaccines and up to 70% of those given a single vaccine. Overall, 16% of infants had vaccine-associated cardiorespiratory events within 48 hours postimmunization. In logistic regression analysis, abnormal CRP values were associated with multiple vaccines (OR, 15.77; 95% CI 5.10-48.77) and severe intraventricular hemorrhage (IVH) (OR, 2.28; 95% CI 1.02-5.13). Cardiorespiratory events were associated marginally with receipt of multiple injections (OR, 3.62; 95% CI 0.99-13.25) and significantly with gastroesophageal reflux (GER) (OR, 4.76; 95% CI 1.22-18.52). Conclusion: CRP level is expected to be elevated in the 48 hours following immunization. In a minority of infants immunized, cardiorespiratory events were associated with presumed need for intervention. Underlying medical conditions and possibly multiple injections are associated with cardiorespiratory events. Precautionary monitoring following immunizations is warranted.

Original languageEnglish (US)
Pages (from-to)167-172
Number of pages6
JournalJournal of Pediatrics
Volume151
Issue number2
DOIs
StatePublished - Aug 1 2007

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Premature Infants
C-Reactive Protein
Gestational Age
Immunization
Vaccines
Injections
Neonatal Intensive Care Units
Gastroesophageal Reflux
Observational Studies
Logistic Models
Regression Analysis
Prospective Studies
Hemorrhage
Incidence

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Primary Immunization of Premature Infants with Gestational Age <35 Weeks: Cardiorespiratory Complications and C-Reactive Protein Responses Associated with Administration of Single and Multiple Separate Vaccines Simultaneously",
abstract = "Objective: To determine the incidence of cardiorespiratory events and abnormal C-reactive protein (CRP) level associated with administration of a single vaccine or multiple separate vaccines simultaneously. Study design: Prospective observational study on 239 preterm infants at ≥2 months of age in the neonatal intensive care unit (NICU). Each infant received either a single vaccine or multiple vaccines on one day. CRP levels and cardiorespiratory manifestations were monitored for 3 days following immunization. Results: Abnormal elevation of CRP level occurred in 85{\%} of infants administered multiple vaccines and up to 70{\%} of those given a single vaccine. Overall, 16{\%} of infants had vaccine-associated cardiorespiratory events within 48 hours postimmunization. In logistic regression analysis, abnormal CRP values were associated with multiple vaccines (OR, 15.77; 95{\%} CI 5.10-48.77) and severe intraventricular hemorrhage (IVH) (OR, 2.28; 95{\%} CI 1.02-5.13). Cardiorespiratory events were associated marginally with receipt of multiple injections (OR, 3.62; 95{\%} CI 0.99-13.25) and significantly with gastroesophageal reflux (GER) (OR, 4.76; 95{\%} CI 1.22-18.52). Conclusion: CRP level is expected to be elevated in the 48 hours following immunization. In a minority of infants immunized, cardiorespiratory events were associated with presumed need for intervention. Underlying medical conditions and possibly multiple injections are associated with cardiorespiratory events. Precautionary monitoring following immunizations is warranted.",
author = "Massroor Pourcyrous and Korones, {Sheldon B.} and Arheart, {Kristopher L.} and Bada, {Henrietta S.}",
year = "2007",
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T2 - Cardiorespiratory Complications and C-Reactive Protein Responses Associated with Administration of Single and Multiple Separate Vaccines Simultaneously

AU - Pourcyrous, Massroor

AU - Korones, Sheldon B.

AU - Arheart, Kristopher L.

AU - Bada, Henrietta S.

PY - 2007/8/1

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N2 - Objective: To determine the incidence of cardiorespiratory events and abnormal C-reactive protein (CRP) level associated with administration of a single vaccine or multiple separate vaccines simultaneously. Study design: Prospective observational study on 239 preterm infants at ≥2 months of age in the neonatal intensive care unit (NICU). Each infant received either a single vaccine or multiple vaccines on one day. CRP levels and cardiorespiratory manifestations were monitored for 3 days following immunization. Results: Abnormal elevation of CRP level occurred in 85% of infants administered multiple vaccines and up to 70% of those given a single vaccine. Overall, 16% of infants had vaccine-associated cardiorespiratory events within 48 hours postimmunization. In logistic regression analysis, abnormal CRP values were associated with multiple vaccines (OR, 15.77; 95% CI 5.10-48.77) and severe intraventricular hemorrhage (IVH) (OR, 2.28; 95% CI 1.02-5.13). Cardiorespiratory events were associated marginally with receipt of multiple injections (OR, 3.62; 95% CI 0.99-13.25) and significantly with gastroesophageal reflux (GER) (OR, 4.76; 95% CI 1.22-18.52). Conclusion: CRP level is expected to be elevated in the 48 hours following immunization. In a minority of infants immunized, cardiorespiratory events were associated with presumed need for intervention. Underlying medical conditions and possibly multiple injections are associated with cardiorespiratory events. Precautionary monitoring following immunizations is warranted.

AB - Objective: To determine the incidence of cardiorespiratory events and abnormal C-reactive protein (CRP) level associated with administration of a single vaccine or multiple separate vaccines simultaneously. Study design: Prospective observational study on 239 preterm infants at ≥2 months of age in the neonatal intensive care unit (NICU). Each infant received either a single vaccine or multiple vaccines on one day. CRP levels and cardiorespiratory manifestations were monitored for 3 days following immunization. Results: Abnormal elevation of CRP level occurred in 85% of infants administered multiple vaccines and up to 70% of those given a single vaccine. Overall, 16% of infants had vaccine-associated cardiorespiratory events within 48 hours postimmunization. In logistic regression analysis, abnormal CRP values were associated with multiple vaccines (OR, 15.77; 95% CI 5.10-48.77) and severe intraventricular hemorrhage (IVH) (OR, 2.28; 95% CI 1.02-5.13). Cardiorespiratory events were associated marginally with receipt of multiple injections (OR, 3.62; 95% CI 0.99-13.25) and significantly with gastroesophageal reflux (GER) (OR, 4.76; 95% CI 1.22-18.52). Conclusion: CRP level is expected to be elevated in the 48 hours following immunization. In a minority of infants immunized, cardiorespiratory events were associated with presumed need for intervention. Underlying medical conditions and possibly multiple injections are associated with cardiorespiratory events. Precautionary monitoring following immunizations is warranted.

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