Iowa Neonatology Handbook: General

Immunization of the Infant in the Hospital

Edward F. Bell, MD
Peer Review Status: Internally Peer Reviewed

1. All infants, pre term or term, who are in the hospital at 2 months of age (chronological, not adjusted) should be considered for initiation of their immunizations.
2. At two, four and six months after birth, give Tetramune (0.5 ml IM), polio vaccine (see point III below). Hepatitis B vaccine (0.5 ml IM) may be given at birth - 2 months of age, then every 2 months for a total of three doses.
3. If the infant is going to remain an inpatient, give one dose (0.5 ml) of inactivated (Salk) polio vaccine subcutaneously. If the infant is being discharged, give one dose of oral trivalent polio vaccine PO immediately prior to discharge.
4. Infants with chronic lung disease who are 6 months or older should be given influenza virus vaccine when available each season (as should their immediate family and hospital caregivers).
5. A signed informed consent is required prior to administration of immunizations.
6. Please mark the immunizations given on the A-9 form ("Vaccination and Diagnostic Screening Examination Record") in the chart and give the parents an immunization card with the dates and vaccines marked. Remind the parents when the next immunizations will be due.
7. Please include the immunization history in the interim, transfer, and discharge summaries, as well as off-service notes.

References:

Bernbaum JC, Daft A, Anolik R, et al. Response of preterm infants to diphtheria-tetanus-pertussis immunizations. J Pediatr 1985;107:184-188.

American Academy of Pediatrics Committee on Infectious Diseases. Report of the Committee on Infectious Diseases. (23rd ed.) Elk Grove Village: American Academy of Pediatrics, 1994:51-52.

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