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Vaccination timeliness in preterm infants: An integrative review of the literature

Sisson, Helen; Gardiner, Eric; Watson, Roger


Eric Gardiner


© 2017 John Wiley & Sons Ltd Aims and objectives: To take a systematic approach to reviewing the scientific literature examining the timeliness of vaccination in preterm infants and to identify any factors associated with timeliness. Background: Preterm infants are vulnerable to infection and guidance advocates they are vaccinated in accordance with their full-term peers. Vaccination is well tolerated and protective immune responses are observed, yet some early enquiries suggest that preterm infants experience unwarranted delays. The recent surge in pertussis cases and the increase in vaccinations administered make this a topic requiring further exploration. Design: An integrative review of the empirical literature. Methods: Studies were identified following a search of Medline, Academic Search Premier, Cochrane Database of Systematic Reviews and the Cumulative Index to Nursing and Allied Health Literature. The review methods used were influenced by a narrative synthesis approach. The retrieval of papers adhered to recognised reporting standards. Results: Fourteen studies were identified, which indicated that infants with the lowest gestational ages and birthweights experience the greatest delays. Vaccination timeliness is influenced by hospitalisation and increased postdischarge follow-up. There was a lack of consensus to indicate that parental socio-economic status and level of education were indicators for a delay. The studies propose that many delays are unjustified and not according to genuine contraindications. Conclusion: This review indicates that preterm infants are not vaccinated in a timely manner. Those involved in vaccinating preterm infants must be informed of the genuine contraindications to avoid unnecessary delays putting preterm infants at an increased risk of infection. Relevance to clinical practice: Care providers should acknowledge the risk of a delay in preterm infants and actively promote vaccination in this population. Regular training should help to negate the occurrence of inappropriate delays, and careful discharge planning is needed to ensure that preterm infants are vaccinated on time.


Sisson, H., Gardiner, E., & Watson, R. (2017). Vaccination timeliness in preterm infants: An integrative review of the literature. Journal of clinical nursing, 26(23-24), 4094-4104.

Journal Article Type Article
Acceptance Date Jun 7, 2017
Online Publication Date Aug 6, 2017
Publication Date 2017-12
Deposit Date Jun 7, 2017
Publicly Available Date Jun 15, 2018
Journal Journal of clinical nursing
Print ISSN 0962-1067
Electronic ISSN 1365-2702
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 26
Issue 23-24
Pages 4094-4104
Keywords Delay, Immunisation, Literature review, Low birth weight, Preterm, Timeliness, Vaccination
Public URL
Publisher URL
Additional Information This is a description of an article published in: Journal of clinical nursing, 2017


Article (232 Kb)

Copyright Statement
This is the peer reviewed version of the following article: Sisson H, Gardiner E, Watson R. Vaccination timeliness in preterm infants: An integrative review of the literature. J Clin Nurs. 2017;26:4094–4104., which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

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