Routine vaccination and insurance in preterm babiesevaluation of delays in vaccination

This study aimed to evaluate the frequency of vaccination in preterm infants, the timing of vaccination initiation, delays in vaccination, reasons for delays and risk factors. The data of 273 preterm infants born between April 1, 2021 and March 31, 2022 who were applied to the Neonatal Intensive Care Unit and Neonatal Outpatient Clinic of Akdeniz University Faculty of Medicine Hospital were evaluated. Patients who died within postnatal 30 days, or had missing data (such as patient-based immunization schedule, gestational age or weight) in hospital information management system records were excluded from the study. Information such as gender, gestational week, birth weight, hospital of birth, duration of hospitalization in the neonatal intensive care unit, death in the first month of life, follow-up in our hospital after discharge; any history of re- hospitalization, primary or secondary immunodeficiency, maternal biological agent or immunosuppressive use; the doses and timing of vaccines administered and the reasons for lapsed or missing immunizations; and parental education level were collected retrospectively from the hospital electronic data system. In our study, it was determined that 3549 (91.8%) of the 3868 doses of vaccines indicated for 273 preterms were administered on time, 202 (5.2%) were delayed and 117 (3%) were not administered. The vaccines included in the routine childhood vaccination schedule in Turkey with the lowest rates of timely administration in the study group were BCG (87.9%), MMR 9th month dose (67.1%) and varicella (88.3%). The reasons for non-administration or delay were often contraindications, overlooking the need for additional doses of vaccine, and logistical problems with some vaccines. When we compared preterms whose vaccines were administered on time and preterms whose vaccines were not administered on time in the first year of life, a significant relation was determined between gestational age and birth weight and timely vaccination rates (p values 0.001 and 0.000, respectively). In order to analyze up till which month timeliness of vaccination was affected by being born preterm, we compared the vaccination status in different chronological age groups (0-2 months, 3-6 months, 7-13 months). While gestational age and birth weight were the limiting factors preventing timely vaccination of preterms in the first six months, there was no statistically significant difference after the seventh month.