Immunisation and vaccination

Development of the immune system

The immune system has the task of fighting pathogens such as bacteria or viruses which sometimes can make us ill. To build up the immune system of a baby, antibodies of the mother are necessary which are normally transferred during pregnancy. Hence preterm babies receive fewer antibodies and, as a result, are more at risk of usually harmless infections.

To ensure that babies can establish sufficient protection against severe infections it is very important that they receive their vaccines according to the recommended guidelines. Vaccines prevent the outbreak of dangerous diseases where suitable therapies are partly missing at present. Consequently, the prevention of serious infections in preterm babies through the use of all effective methods is recommended by health authorities throughout the world.

It is generally indicated that preterm babies should be given vaccines following the same schedule generally used for term babies, without correcting for prematurity and regardless of birth weight. For this reason, the bulk of routine childhood vaccinations starts at the age of eight weeks, no matter how preterm they are.

Immunisation and Vaccination are a crucial aspect of care for in fact every baby. There is a subtle distinction between immunisation and vaccination and in common language both terms are often used synonymously. However, if a baby or child has gotten immune against a disease, the baby has gained immunisation by having caught and overcome a certain infection. A vaccine means the baby is made immune through a certain remedy that is being injected or given in a different pharmacological way.

Safety & tolerability of vaccines in preterm babies

In the first instance, it seems natural to assume that preterm babies may have problems to cope with vaccinations because their bodies might be less developed. In fact, even preterm babies are born with a working immune system. The majority of its structure and functioning is working by fourteen weeks after conception.

For this reason, the immune system of preterm babies will respond to vaccinations. The only repeatedly reported problem for preterm babies is to have apnoea (temporary stopping of breathing) following a vaccination. Therefore, breathing of very preterm babies should be monitored for 48-72 hours after the first set of immunisations and preterm babies are also required to stay in hospital.

Immunisation/Vaccination-preventable diseases

Immunisation by receiving a vaccine helps to protect us from certain serious diseases. Some vaccine-preventable diseases can lead to disability or death, which can be avoided by getting the immunisations timely:

Diphtheria is a potentially fatal, contagious bacterial infection that mainly affects the nose and throat, and sometimes the skin.

Hepatitis B is a virus induced inflammation of the liver. In the majority of cases the infection doesn’t cause any symptoms, however, severe progresses can occur and lead to cirrhosis or cancer of the liver and gastrointestinal bleeding.

HIB (Haemophilus influenza type b) bacteria can cause several serious infections, e.g. an infection of the lining of the brain, blood poisoning, pneumonia or infection of the bones.

Measles are a highly infectious viral illness that can lead to life-threatening complications. These include infections of the lungs and brain. Main indicator of being infected with measles is an extensive red blotchy rash.

Meningococcal disease describes infections caused by a bacterium which affects the lining of the brain.

Mumps is a virus triggered infection which is marked by an intense swelling of the parotid glands (in the ear area). Often an infection continues without any symptoms. However, a complication in boys can be infertility in later life. An effective therapy does not exist.

Pneumococci are bacteria which can be the reason for an infection of the lining of the brain, blood poisoning, pneumonia or infections of the middle ear.

Polio is a serious viral infection. It can cause paralysis, so that an affected person cannot move the legs for a while.

Rotavirus is the most common cause for gastrointestinal infection with vomiting and diarrhoea in small children. The virus is highly contagious.

Respiratory Syncytial Virus (RSV) is a virus that infects the lungs and breathing passages. Initial symptoms often resemble the common cold. If untreated, RSV can lead to bronchiolitis and pneumonia.

Rubella disease is also virus induced and causes fever, a blotchy rash and swollen lymph nodes. During pregnancy rubella may seriously affect the organs of the unborn baby. For this reason, an early and sufficient immunisation of girls is essential.

Tetanus is a serious but rare infection caused by bacteria which enter the body via wounds.

Whooping cough (Pertussis) is a highly contagious bacterial infection of the lungs and airways. It is marked by repeated coughing attacks that can last for months, and can make babies in particular very ill.

Varicella results in its primary virus infection in chickenpox, which is mostly a harmless rash with fever and a general malaise. However, the virus remains in the body and a painful rash with blisters in the area of nerve pathways called shingles, may break out in later life.


Most countries in Europe, North and South America tend to recommend the same kinds of vaccines for babies. However, vaccination schedules can differ from country to country. This is due to differences in the epidemiology of certain diseases in a certain country or because decision makers decide differently on which vaccines shall be offered to whom and when. The image below is an example for recommended immunisations for children from the age of 6 weeks to 18 years in Germany. Click on the link below to find out about the recommendations in other European countries.