Semin Fetal Neonatal Med. 2025 Sep 25:101670. doi: 10.1016/j.siny.2025.101670. Online ahead of print.
ABSTRACT
Preterm infants, who represent around 10 % of births worldwide, are at markedly increased risk of infections due to their immunological immaturity and reduced maternal antibody transfer. Although international guidelines recommend immunization based on chronological age, vaccination in this population is frequently delayed or incomplete. This review summarizes the current evidence on vaccine safety, efficacy, and timing in preterm infants, with particular emphasis on primary immunizations and vaccines administered during the first year of life. Distinct immunological characteristics-including impaired T- and B-cell responses as well as altered microbiome development-contribute to reduced vaccine responsiveness. Emerging approaches such as mRNA vaccine technologies, novel adjuvants, maternal immunization, and microbiome modulation hold promise for enhancing vaccine efficacy. Ensuring timely immunization and adherence to vaccination recommendations in preterm infants is essential to reduce preventable morbidity and mortality in this highly vulnerable group.
PMID:41102028 | DOI:10.1016/j.siny.2025.101670
