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Underimmunization at discharge from the neonatal intensive care unit

Journal of Perinatology volume 32, pages 363–367 (2012)Cite this article

Abstract

Objective:

The objectives of this study are to determine immunization rates at discharge from the neonatal intensive care unit (NICU) among infants 2 months of age and above and to evaluate risk factors for underimmunization.

Study Design:

A retrospective cohort study was performed for infants in six NICUs in the Northern California Kaiser Permanente Medical Care Program. Immunization status at discharge was determined for all infants discharged on or after age 60 days. Logistic regression was used to identify risk factors for underimmunization at the time of discharge.

Result:

Of 668 infants discharged on or after age 60 days from the NICU, 51% were up-to-date for routine immunizations. Twenty-seven percent of infants had received no vaccines. Factors associated with higher immunization rates at discharge include history of mechanical ventilation, congenital heart disease and a diagnosis of apnea or bronchopulmonary dysplasia during the NICU stay, whereas surgery was associated with lower immunization rates.

Conclusion:

A significant proportion of infants discharged on or after 2 months of age in the NICU in this health system was unimmunized or underimmunized at discharge. Further efforts should be made to improve immunization rates prior to discharge.

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Acknowledgements

This study was supported by Clinical Immunization Safety Assessment and Vaccine Safety Datalink contract with America's Health Insurance Plans, funded by the Centers for Disease Control and Prevention. GJE and MLM also received support from The Permanente Medical Group and Kaiser Foundation Hospitals. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Departments of Internal medicine and Pediatrics, Duke University Medical Center, Durham, NC, USA

    A M Navar-Boggan

  2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    A M Navar-Boggan & N A Halsey

  3. Division of Research, Kaiser Permanente Northern California and Division of Research, Perinatal Research Unit, Oakland, CA, USA

    G J Escobar

  4. Eudowood Neonatal Pulmonary Division, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    W C Golden

  5. Kaiser Permanente Vaccine Study Center, Oakland, CA, USA

    N P Klein

Authors
  1. A M Navar-Boggan
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  2. N A Halsey
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  3. G J Escobar
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  4. W C Golden
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  5. N P Klein
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Corresponding author

Correspondence to A M Navar-Boggan.

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Competing interests

We report the following potential conflicts of interest: AMNB, WCG and GJE declare no financial conflicts of interest. NH has received compensation for serving on Safety Monitoring committees for Novartis and Merck, has research grants through Johns Hopkins University from Crucell, Merck, and Intercell for studies of unrelated vaccines in Guatemala and Peru. NK has received research support from GlaxoSmithKline, Sanofi Pastuer, Novartis, Wyeth and Merck.

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Navar-Boggan, A., Halsey, N., Escobar, G. et al. Underimmunization at discharge from the neonatal intensive care unit. J Perinatol 32, 363–367 (2012). https://doi.org/10.1038/jp.2011.111

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  • DOI: https://doi.org/10.1038/jp.2011.111

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