Abstract
The fetus can be compared to a haploidentical graft, sharing only half of the histocompatibility antigens of the “mother host.” As such, the fetus should be rejected by the immune system of the mother. At the same time, since the fetal immune system starts developing around the ninth week of gestation, the fetus should also mount a “graft-versus-host” reaction against those histocompatibility antigens that it has not inherited from the “mother host.” It follows that survival of the fetus – indeed of all mammalian species – is strictly dependent on a wide variety of mechanisms preventing graft rejection by the mother and graft-versus-host reaction by the fetus (Koch CA, Platt JL, Cell Immunol 248: 12–7, 2007). Among the latter, a major role is certainly played by the slow intrauterine maturation of the fetal immune function, ultimately resulting in the physiological immune deficiency of the neonate that involves both innate and adaptive immunity. This immune immaturity – more severe in preterm and in very low birth weight infants – results in a weak immune response to antigen challenge and in the production of a poor immunological memory (Lewis DB, The physiologic immunodeficiency of immaturity. In: Stiehm ER, Ochs HD, Winkelstein JA (eds) Immunologic disorders in infants and children, 5th edn. Elsevier Saunders, Philadelphia, pp 687–760, 2004).
Similar content being viewed by others
References
Adenyi-Jones SC, Faden H, Ferdon MB et al (1992) Systemic and local immune responses to enhanced-potency inactivated poliovirus vaccine in premature and term infants. J Pediatr 120:686–689
American Academy of Pediatrics (2003) Hepatitis B. In: Pickering LK (ed) Red book: 2003 report of the committee on infectious diseases, 26th edn. American Academy of Pediatrics, Elk Grove Village, pp 318–336
Basha S, Surendram N, Pichichero M (2014) Immune responses in neonates. Expert Rev Immunol 10(9):1171–1184
Berrington JE, Cant AJ, Matthews JN et al (2006) Haemophilus influenzae type b immunization in infants in the United Kingdom: effects of diphtheria/tetanus/acellular pertussis/Hib combination vaccine, significant prematurity, and a fourth dose. Pediatrics 117:e717–e724
Bonhoeffer J, Siegrist C-A, Heath PT (2006) Immunisation of premature infants. Arch Dis Child 91:929–935
Carbone T, McEntire B, Kissin D et al (2008) Absence of an increase in cardiorespiratory events after diphtheria-tetanus-acellular pertussis immunization in preterm infants: a randomized, multicenter study. Pediatrics 121:e1085–e1090
Centers for Disease Control and Prevention (1999) Thimerosal in vaccines: a joint statement of the American academy of pediatrics and the public health service. MMWR Morb Mortal Wkly Rep 48:563–565
Chu HY, Englund JA (2014) Maternal immunization. Vaccine 59:560–568
Clarke P, Powell PJ, Goldblatt D, Robinson MJ (2003) Effect of a fourth Haemophilus influenzae type b immunization in preterm infants who received dexamethasone for chronic lung disease. Arch Dis Child Fetal Neonatal Ed 88:F58–F61
Clarke P, Robinson MJ, Ahmad I et al (2006) Response of steroid treated former preterm infants to a single dose of meningococcal C conjugate vaccine. Vaccine 24:3273–3278
ClinicalTrials.gov (2015) A study to determine the safety and efficacy of the RSV F vaccine to protect infants via maternal immunization (NIH: https://clinicaltrials.gov/ct2/show/NCT02624947)
Collins CL, Ruggeberg JU, Balfour G et al (2005) Immunogenicity and immunologic memory of meningococcal C conjugate vaccine in premature infants. Pediatr Infect Dis J 24:966–968
Conway S, James J, Balfour A, Smithells R (1994) Immunisation of the preterm baby. J Infect 28:143–150
D’Angio CT, Maniscalco WM, Pichichero ME (1995) Immunologic response of extremely premature infants to tetanus, Haemophilus influenzae, and polio immunizations. Pediatrics 96:18–22
D’Angio CT, Boohene PA, Mowrer A et al (2007) Measles-mumps-rubella and varicella vaccine responses in extremely preterm infants. Pediatrics 119:e574–e579
Esposito S, Pugni L, Bosis S et al (2005) Immunogenicity, safety and tolerability of heptavalent pneumococcal conjugate vaccine administered at 3, 5 and 11 months post-natally to pre- and full-term infants. Vaccine 23:1703–1708
European Agency for the Evaluation of Medicinal Products (2009) EMEA public statement on thiomersal containing medicinal products, 8 July 1999. www.emea.europa.eu/pdfs/human/press/pus/2096299EN.pdf
Faldella G, Galletti S, Corvaglia L et al (2007) Safety of DTaPIPV- HIb-HBV hexavalent vaccine in very premature infants. Vaccine 25:1036–1042
Flatz-Jequier A, Posfay-Barbe KM, Pfister RE, Siegrist CA (2008) Recurrence of cardiorespiratory events following repeat DTaPbased combined immunization in very low birth weight premature infants. J Pediatr 153:429–431
Forsyth K, Plotkin S, Tan T, Wirsing von König CH (2015) Strategies to decrease pertussis transmission to infants. Pediatrics 135(6):e1475–e1482
Gagneur A, Pinquier D, Quach C (2015) Immunization of preterm infants. Hum Vaccin Immunother 11(11):2556–2563
Gaudelus J, Lefèvre-Akriche S, Roumegoux C et al (2007) Immunization of the preterm infants. Arch Pediatr 14(Suppl 1):S24–S30
Groothuis JR, Levin MJ, Lehr MV et al (1992) Immune response to split-product influenza vaccine in preterm and full-term young children. Vaccine 10:221–225
Heath PT, Booy R, McVernon J et al (2003) Hib vaccination in infants born prematurely. Arch Dis Child 88:206–210
Heyderman RS, Madhi SA, Neil F, Clare C, Bagrey N, Doris K, Robert M, Anthonet K, Lisa J, Morounfolu O, Frederik W, Karen S, Dull PM (2016) Group B streptococcus vaccination in pregnant women with or without HIV in AFRICA: a non-randomised phase 2, open-label, multicentre trial. Lancet 16:546–555
Huang FY, Lee PI, Lee CY et al (2007) Hepatitis B vaccination in preterm infants. Arch Dis Child Fetal Neonatal Ed 77:F135–F138
Kim SC, Chung EK, Hodinka RL et al (1997) Immunogenicity of hepatitis B vaccine in preterm infants. Pediatrics 99:534–536
Klein NP, Massolo ML, Greene J et al (2008) Vaccine safety datalink. Risk factors for developing apnea after immunization in the neonatal intensive care unit. Pediatrics 121:463–469
Klinman DM (2004) Immunotherapeutic uses of CpG oligodeoxynucleotides. Nat Rev Immunol 4:249–258
Koch CA, Platt JL (2007) T cell recognition and immunity in the fetus and mother. Cell Immunol 248:12–7
Kroger AT, Atkinson WL, Marcuse EK et al (2006) General recommendations on immunization recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep 55:1–48
Langkamp DL, Hoshaw-Woodard S, Boye ME, Lemeshow S (2001) Delays in receipt of immunizations in low-birth-weight children: a nationally representative sample. Arch Pediatr Adolesc Med 155:167–172
Lau YL, Tam AY, Ng KW et al (1992) Response of preterm infants to hepatitis B vaccine. J Pediatr 121:962–965
Lewis DB (2004) The physiologic immunodeficiency of immaturity. In: Stiehm ER, Ochs HD, Winkelstein JA (eds) Immunologic disorders in infants and children, 5th edn. Elsevier Saunders, Philadelphia, pp 687–760
Linder N, Yaron M, Handsher R et al (1995) Early immunization with inactivated poliovirus vaccine in premature infants. J Pediatr 127:128–130
Madhi SA, Dangor Z, Heath PT, Schrag S, Izu A, Sobanjo-Ter Meulen A, Dull PM (2013) Considerations for a phase-III trial evaluate a group B Streptococcus polysaccharide-èrptein conjugate vaccine in pregnant women for the prevention of early- and late-onset invasive disease in young-infants. Vaccine 31(Suppl 4):D52–D57
Madhi SA, Cutland CL, Jose L, Koen A, Govender N, Wittke F, Olugbosi M, Meulen AS, Baker S, Dull PM, Narasimhan V, Slobod K (2016) Safety and immunogenicity of an investigational maternal trivalent group B Streptococcus vaccine in healthy women and their infants: a randomized phase 1b/2 trial. Lancet 1–12
Martinón-Torres F, Czajka H, Center KJ, Wysocki J, Ewa M-S, Omeñaca F, Iturbe EB, Gamero DB, Concheiro-Guisán A, Gimenez-Sanchez F, Szenborn L, Giardina PC, Patterson S, Gruber WC, Scott DA, Gurtman A (2015) 13-valent pneumococcal conjugate vaccine (PCV13) in preterm versus term infants. Pediatrics 135:e877–e886
Mast EE, Margolis HS, Fiore AE et al (2005) A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the advisory committee on immunization practices (ACIP); part 1: immunization of infants, children, and adolescents. MMWR Recomm Rep 54:1–31
McCormick M, Bayer R, Berg A (2004) Report of the institute of medicine: immunization safety review–vaccines and autism. National Academy Press, Washington, DC
Moyes C (1999) Immunisation of preterm babies. N Z Med J 112:263–264
Negrete-Esqueda L, Vargas-Origel A (2007) Response to Bacillus Calmette-Guerìn vaccine in full term and pre term infants. Am J Perinatol 24:183–189
Okan F, Karagoz S, Nuhoglu A (2006) Bacillus Calmette-Guerìn vaccination in preterm infants. Int J Tuberc Lung Dis 10:1337–1341
Omeñaca F, Garcia-Sicilia J, García-Corbeira P et al (2005) Response of preterm newborns to immunization with a hexavalent diphtheria-tetanus-acellular pertussis-hepatitis B virus-inactivated polio and Haemophilus influenzae type b vaccine: first experiences and solutions to a serious and sensitive issue. Pediatrics 116:1292–1298
Omeñaca F, Garcia-Sicilia J, García-Corbeira P et al (2007) Antipolyribosyl ribitol phosphate response of premature infants to primary and booster vaccination with a combined diphtheriatetanus- acellular pertussis-hepatitis B-inactivated polio virus/Haemophilus influenzae type b vaccine. Pediatrics 119:e179–e185
Pfister RE, Aeschbach V, Niksic-Stuber V et al (2004) Safety of DTaP-based combined immunization in very-low-birth-weight premature infants: frequent but mostly benign cardiorespiratory events. J Pediatr 145:58–66
Plotkin S (2005) Vaccines: past, present, and future. Nat Med 11:S5–S11
Pourcyrous M, Korones SB, Arheart KL, Bada HS (2007) 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. J Pediatr 151:167–172
Robinson MJ, Heal C, Gardener E et al (2004) Antibody response to diphtheria-tetanus-pertussis immunization in preterm infants who receive dexamethasone for chronic lung disease. Pediatrics 113:733–737
Ruggeberg JU, Collins C, Clarke P et al (2007) Immunogenicity and induction of immunological memory of the heptavalent pneumococcal conjugate vaccine in preterm UK infants. Vaccine 25:264–271
Saari TN, Committee on Infectious Diseases (2003) Immunization of preterm and low birth weight infants. Pediatrics 112:193–198
Salious P, Aijan N, Guérin N (2002) Efficacy and tolerance of vaccinations in premature infants. Arch Pediatr 9:629–637
Schloesser RL, Fischer D, Otto W et al (1999) Safety and immunogenicity of an acellular pertussis vaccine in premature infants. Pediatrics 103:e60
Shinefield H, Black S, Ray P et al (2002) Efficacy, immunogenicity and safety of heptavalent pneumococcal conjugate vaccine in low birth weight and preterm infants. Pediatr Infect Dis J 21:182–186
Slack MH, Schapira D, Thwaites RJ et al (2001) Immune response of premature infants to meningococcal serogroup C and combined diphtheria-tetanus toxoids-acellular pertussis-Haemophilus influenzae type b conjugate vaccines. J Infect Dis 184:1617–1620
Slack MH, Cade S, Schapira D et al (2005) DT5aP-Hib-IPV and MCC vaccines: preterm infants’ response to accelerated immunisation. Arch Dis Child 90:338–341
Swamy GK, Heine RP (2015) Vaccinations for pregnant women. Clin Expert Ser 125(1):212–226
Tozzi AE, Bisiacchi P, Tarantino V et al (2009) Neuropsychological performance 10 years after immunization in infancy with thimerosal-containing vaccines. Pediatrics 123:475–482
Tozzi AE, Piga S, Corchia C, Di Lallo D, Carnielli V, Chiandotto V, Fertz MC, Miniaci S, Rusconi F, Cuttini M (2014) Timeliness of routine immunization in a population-based Italian cohort of very preterm infants: results of the ACTION follow-up project. Vaccine 32(7):793–799
Vázquez L, Garcia F, Rüttimann R et al (2008) Immunogenicity and reactogenicity of DTPa-HBV-IPV/Hib vaccine as primary and booster vaccination in low-birth-weight premature infants. Acta Paediatr 97:1243–1249
Velasco C, Helene B, Bipin B, Fallon JT, Alexandra A, Paul G, Galarza JM (2016) A novel respiratory syncytial virus-like particle (VLP) vaccine composed of the postfusion and prefusion conformations of the F glycoprotein. Clin Vaccine Immunol 23:451–459
Vesikari T, Matson DO, Dennehy P et al (2006) Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine. N Engl J Med 354:23–33
Watson PS, Turner DP (2016) Clinical experience with the meningococcal B vaccine, Bexsero: prospects for reducing the burden of meningococcal serogroup B disease. Vaccine 34(7):875–880
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this entry
Cite this entry
Ugazio, A.G., Tozzi, A.E. (2016). Vaccinations and Neonatal Immunity. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-18159-2_257-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-18159-2_257-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Online ISBN: 978-3-319-18159-2
eBook Packages: Springer Reference MedicineReference Module Medicine