Author/Editor		Bregant, L; Kraigher, A
Title		Pomen zgodnjega cepljenja pri nedonošenčkih
Translated title		The importance of early vaccination of premature born infants
Type		članek
Source		Slov Pediatr
Vol. and No.		Letnik 8, št. 4
Publication year		2001
Volume		str. 92-6
Language		slo
Abstract		The article deals with the importance of early vaccination against paediatric infectious diseases (diphtheria, whooping cough, poliomyelitis, Haemophilus influenzae type b) in preterm babies. Vaccination at the same chronological age as term babies may provide appropriate individual protection and herd immunity. In Slovenia about 6% of babies annually are born before the 37th gestational week; among these, there are almost 100 weighing less than 1000 g. In spite of limited functions of the immunological system in preterm babies, due to reduced proliferation of polymorphonuclear leukocytes, their lower phagocyte potential, reduced activity of the complement system and lower cytokyne production, vaccination at the same chronological age as in term babies provides a sufficient immunological response and appropriate protection. In Slovenia, various vaccines are at our disposal free of charge. There are monovalent or combined polyvalent vaccines, and live, killed or inactivated vaccines. The further choice depends on adjuvants and especially antibiotics, preservatives and stabilizers. Most studies do not find an increased incidence of side effects or allergy in preterm babies. Therefore, it is advisable to follow the recommendation that preterm babies be vaccinated at the same chronological age as term babies. The Committee for Contraindications nominated by the Ministry of Health decides on a permanent contraindication for a certain vaccine.
Summary		V Sloveniji letno rodi okoli 6% žensk pred 37. tednom nosečnosti. Skoraj 100 nedonošenčkov tehta komaj en kilogram ali celo manj. Ti novorojenčki imajo omejeno sposobnost imunskega sistema zaradi počasnejšega nastajanja polimorfonuklearnih levkocitov, manjšo fagocitno sposobnost, znižano aktivnost sistema komplementa in manjšo tvorbo citokinov. Kljub temu je znano, da tudi nedonošenček, cepljen v isti kronološki starosti kot donošeni otrok, doseže zadosten imunski odgovor in ustrezno zaščito pred nalezljivimi boleznimi. Zgodnji začetek cepljenja proti težkim nalezljivim boleznim, kot so davica, tetanus, oslovski kašelj, otroška paraliza in meningitis, povzročen s Haemophilusom influenzae tipa b, je tudi pri nedonošenčkih zelo pomemben. Program cepljenja v Sloveniji je podoben kot v večini evropskih držav. Zadnja leta dosegamo primeren delež cepljenih otrok ter s tem dosežemo poleg individualne tudi ustrezno kolektivno zaščito, ki zavaruje redke necepljene otroke. Na voljo imamo monovalentna in kombinirana cepiva, le-ta so lahko živa ali mrtva. Večina cepiv ne vsebuje tiomersala, dodani pa so stabilizatorji. Kljub temu, da so cepiva varna, pred cepljenjem ugotavljamo morebitne kontraindikacije. O trajni kontraindikaciji za določeno cepljenje odloča komisija pri Ministrstvu za zdravstvo. Stranski učinki po cepljenju nedonošenčkov so redki in enako pogosti kot pri donošenih otrocih, kar velja tudi za pojav anafilaktične reakcije po cepljenju. Vse to so osnove za navodilo, da ni potrebno odlašati s cepljenjem nedonošenčkov in otrok z nizko porodno težo, in za priporočilo, da naj bodo nedonošenčki cepljeni proti davici, tetanusu, oslovskemu kašlju in otroški paralizi, ko dosežejo kronološko starost, pri kateri pričnemo s cepljenjem pravočasno rojenih otrok.
Descriptors		INFANT, PREMATURE INFANT, VERY LOW BIRTH WEIGHT VACCINATION IMMUNIZATION SCHEDULE INFANT BCG VACCINE DIPHTHERIA-TETANUS-PERTUSSIS VACCINE POLIOVIRUS VACCINE, ORAL