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Delayed Start of Routine Vaccination in Preterm and Small-for-Gestational-Age Infants: An Area-Based Cohort Study from the Tuscany Region, Italy

1
Epidemiology Unit, Meyer Children’s Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy
2
Observatory of Epidemiology, Regional Health Agency of Tuscany, Via Pietro Dazzi, 1, 50141 Florence, Italy
3
Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy
4
Neonatology and Neonatal Intensive Care Unit, Azienda Sanitaria Locale Toscana Centro, Piazza Santa Maria Nuova, 1, 50122 Firenze, Italy
5
Neonatal Intensive Care Unit, Meyer Children’s Hospital, Viale Gaetano Pieraccini 24, 50139 Florence, Italy
6
Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Via Cocchi 7/9, 56121 Pisa, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Giuseppe La Torre
Vaccines 2022, 10(9), 1414; https://doi.org/10.3390/vaccines10091414
Received: 6 July 2022 / Revised: 24 August 2022 / Accepted: 25 August 2022 / Published: 28 August 2022
Preterm and small-for-gestational-age (SGA) infants are more susceptible to vaccine-preventable diseases. To evaluate routine vaccination timeliness in these high-risk groups, a full birth cohort of infants (n = 41,502) born in 2017 and 2018 in Tuscany was retrospectively followed up until 24 months of age. Infants were classified by gestational age (GA) and SGA status. The vaccinations included: hexavalent (HEXA), measles-mumps-rubella, varicella, pneumococcal conjugate (PCV), and meningococcal C conjugate. Time-to-event (Kaplan–Meier) analyses were conducted to evaluate the timing of vaccination according to GA; logistic models were performed to evaluate the associations between GA and SGA with vaccination timeliness. Time-to-event analyses show that the rate of delayed vaccine receipt increased with decreasing GA for all the vaccinations, with a less marked gradient in later vaccine doses. Compared to full-term infants, very preterm infants significantly showed an increased odds ratio (OR) for delayed vaccination in all the vaccinations, while moderate/late preterm infants only showed an increased OR for HEXA-1, HEXA-3, PCV-1, and PCV-3. SGA infants had a significantly higher risk of delayed vaccination only for HEXA-1 and PCV-1 compared to non-SGA infants. In conclusion, vaccinations among preterm and SGA infants showed considerable delay. Tailored public health programs to improve vaccination timeliness are required in these high-risk groups. View Full-Text
Keywords: preterm infants; full-term infants; small for gestational age; routine vaccinations; vaccination; immunization; timeliness; delay; area-based cohort; full birth cohort preterm infants; full-term infants; small for gestational age; routine vaccinations; vaccination; immunization; timeliness; delay; area-based cohort; full birth cohort
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MDPI and ACS Style

Lastrucci, V.; Puglia, M.; Pacifici, M.; Buscemi, P.; Sica, M.; Alderotti, G.; Belli, G.; Berti, E.; Rusconi, F.; Voller, F. Delayed Start of Routine Vaccination in Preterm and Small-for-Gestational-Age Infants: An Area-Based Cohort Study from the Tuscany Region, Italy. Vaccines 2022, 10, 1414. https://doi.org/10.3390/vaccines10091414

AMA Style

Lastrucci V, Puglia M, Pacifici M, Buscemi P, Sica M, Alderotti G, Belli G, Berti E, Rusconi F, Voller F. Delayed Start of Routine Vaccination in Preterm and Small-for-Gestational-Age Infants: An Area-Based Cohort Study from the Tuscany Region, Italy. Vaccines. 2022; 10(9):1414. https://doi.org/10.3390/vaccines10091414

Chicago/Turabian Style

Lastrucci, Vieri, Monia Puglia, Martina Pacifici, Primo Buscemi, Michela Sica, Giorgia Alderotti, Gilda Belli, Elettra Berti, Franca Rusconi, and Fabio Voller. 2022. "Delayed Start of Routine Vaccination in Preterm and Small-for-Gestational-Age Infants: An Area-Based Cohort Study from the Tuscany Region, Italy" Vaccines 10, no. 9: 1414. https://doi.org/10.3390/vaccines10091414

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