A 4-month-old preterm infant (birth weight 2.0 kg) presents for vaccination today. Which immunizations are appropriate?

A 4-month-old preterm infant (birth weight 2.0 kg) presents for vaccination today. Which immunizations are appropriate?

• A. DTaP, Hib, IPV, PCV 7
• B. DTaP, Hib, Hep B-3, PCV 7
• C. Hold off on immunizations until term
• D. DTaP, Hib, IPV, HepB-3

Answer: (A)

Immunizations are given according to chronological age, not corrected gestational age. A 4-month-old preterm infant should receive the second doses of DTaP, Hib, IPV, and PCV (often labeled PCV7). The hepatitis B series is completed by 6–18 months, with the third dose given at that window, not at 4 months. Holding off until term isn’t necessary, and including HepB-3 at this visit would be premature. So the appropriate vaccines to administer now are DTaP, Hib, IPV, and PCV7, with HepB-3 deferred until the 6–18 month window.

Immunizations are given according to chronological age, not corrected gestational age. A 4-month-old preterm infant should receive the second doses of DTaP, Hib, IPV, and PCV (often labeled PCV7). The hepatitis B series is completed by 6–18 months, with the third dose given at that window, not at 4 months. Holding off until term isn’t necessary, and including HepB-3 at this visit would be premature. So the appropriate vaccines to administer now are DTaP, Hib, IPV, and PCV7, with HepB-3 deferred until the 6–18 month window.