NEONATAL IMMUNIZATION

INTRODUCTION: Neonates and infants suffer a high frequency and

severity of microbial infection resulting in millions of deaths worldwide.
The same immune deficiencies that render newborns susceptible to
infection also reduce their memory responses to most antigens, thereby
potentially frustrating efforts to protect this high-risk population. As
birth is the most reliable point of healthcare contact worldwide and
effective vaccination at birth would provide early protection for
newborns and infants, expanding and improving the available means of
.neonatal vaccination is a global health priority

Great strides in vaccine development over the last century have resulted
in a number of effective vaccines being given in early life, but only (BCG),
hepatitis B (HBV), and polio vaccine [oral polio vaccine (OPV); or
inactivated polio vaccine (IPV)] have been routinely recommended at
birth. For some pathogens, including pertussis and tuberculosis (TB),
better vaccines are needed, while for others such as human
immunodeficiency virus (HIV), efficacious vaccines have yet to be
developed and licensed for any age group. Among the approaches to
improving protection against infection in early life, neonatal
.immunization is ripe for further research and development

Neonatal Vaccines:
Hepatitis B Vaccine:
Hepatitis B is a serious disease that affects the liver. It is caused by the
hepatitis B virus. Hepatitis B can cause mild illness lasting a few weeks,
or it can lead to a serious, lifelong illness.

Hepatitis B vaccine can prevent hepatitis B and its consequences,

including liver cancer and cirrhosis and is made from parts of the
hepatitis B virus. It cannot cause hepatitis B infection. The vaccine is
usually given as 2, 3, or 4 shots over 1 to 6 months. Infants should get
their first dose of hepatitis B vaccine at birth and will usually complete
the series at 6 months of age.All children and adolescents younger than
19 years of age who have not yet gotten the vaccine should also be
vaccinated.Hepatitis B vaccine is recommended for unvaccinated adults
who are at risk for hepatitis B virus infection.

PEOPLE SHOULD NOT GET THIS VACCINE

 If the person getting the vaccine has any severe, life-

threatening allergies. 
If you ever had a life-threatening allergic reaction after a dose of
hepatitis B vaccine, or have a severe allergy to any part of this
vaccine, you may be advised not to get vaccinated. Ask your health
care provider if you want information about vaccine components.
 If the person getting the vaccine is not feeling well. 
If you have a mild illness, such as a cold, you can probably get the
vaccine today. If you are moderately or severely ill, you should
probably wait until you recover. Your doctor can advise you.

HIV Vaccines: It is important to conduct research to find an effective

vaccine because:

 The availability of a safe, highly effective and accessible

preventive HIV vaccine would be a valuable complement to other
preventive interventions, significantly contributing to the
interruption of the chain of transmission of HIV.
 Well conceived HIV immunization strategies could reach
populations where other interventions are not sufficiently effective.
 Research on preventive HIV vaccines is providing new
information on the possible use of vaccines as therapeutic
interventions.

Therapeutic Vaccines

The HIV vaccines discussed above are intended to be preventive

vaccines. That is, they are designed to prevent HIV from infecting the
body. A therapeutic vaccine is a different kind of vaccine design, one that
would be used after infection already has occurred. Most researchers
think that a therapeutic HIV vaccine would not be a cure – that is, it
probably would not rid the body of virus and lead to stopping anti-
retroviral therapy. However, such a vaccine could boost the body’s
immune response to the virus, thus reducing the amount of virus in the
body, reducing the risk of serious disease, and possibly reducing the dose
of antiretroviral drugs needed.

TB Vaccine (BCG):
Bacille Calmette-Guérin (BCG) is a vaccine for tuberculosis (TB)
disease. This vaccine is not widely used in the United States, but it is
often given to infants and small children in other countries where TB is
common. BCG does not always protect people from getting TB.

BCG Recommendations

In the United States, BCG should be considered for only very select
people who meet specific criteria and in consultation with a TB expert.
Health care providers who are considering BCG vaccination for their
patients are encouraged to discuss this intervention with the TB control
program in their area.

Children

BCG vaccination should only be considered for children who have a

negative TB test and who are continually exposed, and cannot be
separated from adults who

 Are untreated or ineffectively treated for TB disease, and the child

cannot be given long-term primary preventive treatment for TB
infection; or
 Have TB disease caused by strains resistant to isoniazid and
rifampin.

Health Care Workers

BCG vaccination of health care workers should be considered on an

individual basis in settings in which

 A high percentage of TB patients are infected with TB strains

resistant to both isoniazid and rifampin;
 There is ongoing transmission of drug-resistant TB strains to health
care workers and subsequent infection is likely; or
 Comprehensive TB infection-control precautions have been
implemented, but have not been successful.

Health care workers considered for BCG vaccination should be counseled

regarding the risks and benefits associated with both BCG vaccination
and treatment of latent TB infection.