Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes
Background: Very-low-birth-weight infants (VLBWIs; birth weight < 1500 g) are at an increased risk of complicated influenza infection, which frequently includes pneumonia, encephalitis or even death. Data on influenza immunization and its outcome in VLBWIs are scarce. This study aimed to provide...
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2025-01-01
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| Online Access: | https://www.mdpi.com/2076-393X/13/1/42 |
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| author | Marie-Theres Dammann Hannah Kraft Guido Stichtenoth Kathrin Hanke Michael Zemlin Janina Soler Wenglein Isabell Ricklefs Alexander Herz Alexander Humberg Dorothee Viemann Geraldine Engels Matthias Volkmar Kopp Folke Brinkmann Carsten Fortmann-Grote Wolfgang Göpel Egbert Herting Christoph Härtel Ingmar Fortmann on behalf of the German Neonatal Network |
| author_facet | Marie-Theres Dammann Hannah Kraft Guido Stichtenoth Kathrin Hanke Michael Zemlin Janina Soler Wenglein Isabell Ricklefs Alexander Herz Alexander Humberg Dorothee Viemann Geraldine Engels Matthias Volkmar Kopp Folke Brinkmann Carsten Fortmann-Grote Wolfgang Göpel Egbert Herting Christoph Härtel Ingmar Fortmann on behalf of the German Neonatal Network |
| author_sort | Marie-Theres Dammann |
| collection | DOAJ |
| description | Background: Very-low-birth-weight infants (VLBWIs; birth weight < 1500 g) are at an increased risk of complicated influenza infection, which frequently includes pneumonia, encephalitis or even death. Data on influenza immunization and its outcome in VLBWIs are scarce. This study aimed to provide epidemiological data on influenza immunization for German VLBWIs and hypothesized that immunization would protect VLBWIs from infection-mediated neurodevelopmental impairment and preserves lung function at early school age. Methods: In this observational population-based German Neonatal Network (GNN) study, infants born between 2009 and 2015 were invited to partake in a 6-year follow-up investigation including lung function and developmental testing. Uni- and multivariate analyses were performed to evaluate the clinical characteristics and outcomes of influenza-immunized VLBWIs compared to non-immunized VLBWIs. Results: Influenza immunization was performed in 871 out of the 3358 VLBWIs (26%) with six-year follow-up. Immunized infants were characterized by a low gestational age and higher rates of morbidity, particularly bronchopulmonary dysplasia. Although early immunization showed no safety signals and had protective effects on the long-term risk of bronchitis (OR: 0.2; CI: 0.1–0.6; <i>p</i> = 0.002), most VLBWIs (88.0%) were unimmunized in their first influenza season. Conclusions: Influenza immunization was not associated with improved lung function (forced expiratory volume in one second and forced vital capacity) or a better neurocognitive outcome (intelligence quotient and strengths and difficulties questionnaire) at early school age. In Germany, only one quarter of 6-year-old VLBWIs were immunized against influenza, particularly those born <28 gestational weeks and/or BPD. Specific influenza immunization guidelines that define evidence-based recommendations are needed for this vulnerable group. |
| format | Article |
| id | doaj-art-340e3550e77c4431bb210db9494791ec |
| institution | Kabale University |
| issn | 2076-393X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj-art-340e3550e77c4431bb210db9494791ec2025-01-24T13:51:45ZengMDPI AGVaccines2076-393X2025-01-011314210.3390/vaccines13010042Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term OutcomesMarie-Theres Dammann0Hannah Kraft1Guido Stichtenoth2Kathrin Hanke3Michael Zemlin4Janina Soler Wenglein5Isabell Ricklefs6Alexander Herz7Alexander Humberg8Dorothee Viemann9Geraldine Engels10Matthias Volkmar Kopp11Folke Brinkmann12Carsten Fortmann-Grote13Wolfgang Göpel14Egbert Herting15Christoph Härtel16Ingmar Fortmann17on behalf of the German Neonatal Network18Department of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of General Pediatrics and Neonatology, Saarland University, 66123 Homburg, GermanyDepartment of Pediatrics, Protestant Hospital of the Bethel Foundation, Medical School and University Medical Center East Westphalia-Lippe, Bielefeld University, 33617 Bielefeld, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of General Pediatrics, University Children’s Hospital Münster, 48149 Münster, GermanyCenter for Infection Research, University of Würzburg, 97080 Würzburg, GermanyDepartment of Pediatrics, University of Würzburg, 97080 Würzburg, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyScientific Computing Unit, Department of Microbial Population Biology, Max-Plank-Institute for Evolutionary Biology, 24306 Plön, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyDepartment of Pediatrics, University of Würzburg, 97080 Würzburg, GermanyDepartment of Pediatrics, University Hospital of Lübeck, 23538 Lübeck, GermanyAirway Research Center North, German Center of Lung Research (DZL), 23562 Lübeck, GermanyBackground: Very-low-birth-weight infants (VLBWIs; birth weight < 1500 g) are at an increased risk of complicated influenza infection, which frequently includes pneumonia, encephalitis or even death. Data on influenza immunization and its outcome in VLBWIs are scarce. This study aimed to provide epidemiological data on influenza immunization for German VLBWIs and hypothesized that immunization would protect VLBWIs from infection-mediated neurodevelopmental impairment and preserves lung function at early school age. Methods: In this observational population-based German Neonatal Network (GNN) study, infants born between 2009 and 2015 were invited to partake in a 6-year follow-up investigation including lung function and developmental testing. Uni- and multivariate analyses were performed to evaluate the clinical characteristics and outcomes of influenza-immunized VLBWIs compared to non-immunized VLBWIs. Results: Influenza immunization was performed in 871 out of the 3358 VLBWIs (26%) with six-year follow-up. Immunized infants were characterized by a low gestational age and higher rates of morbidity, particularly bronchopulmonary dysplasia. Although early immunization showed no safety signals and had protective effects on the long-term risk of bronchitis (OR: 0.2; CI: 0.1–0.6; <i>p</i> = 0.002), most VLBWIs (88.0%) were unimmunized in their first influenza season. Conclusions: Influenza immunization was not associated with improved lung function (forced expiratory volume in one second and forced vital capacity) or a better neurocognitive outcome (intelligence quotient and strengths and difficulties questionnaire) at early school age. In Germany, only one quarter of 6-year-old VLBWIs were immunized against influenza, particularly those born <28 gestational weeks and/or BPD. Specific influenza immunization guidelines that define evidence-based recommendations are needed for this vulnerable group.https://www.mdpi.com/2076-393X/13/1/42immunizationinfluenzaVLBWIlung function |
| spellingShingle | Marie-Theres Dammann Hannah Kraft Guido Stichtenoth Kathrin Hanke Michael Zemlin Janina Soler Wenglein Isabell Ricklefs Alexander Herz Alexander Humberg Dorothee Viemann Geraldine Engels Matthias Volkmar Kopp Folke Brinkmann Carsten Fortmann-Grote Wolfgang Göpel Egbert Herting Christoph Härtel Ingmar Fortmann on behalf of the German Neonatal Network Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes Vaccines immunization influenza VLBWI lung function |
| title | Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes |
| title_full | Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes |
| title_fullStr | Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes |
| title_full_unstemmed | Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes |
| title_short | Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes |
| title_sort | influenza immunization in very low birth weight infants epidemiology and long term outcomes |
| topic | immunization influenza VLBWI lung function |
| url | https://www.mdpi.com/2076-393X/13/1/42 |
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