Pediatrics and Neonatology

Neonatal Vaccination

Neonates and young infants are less protected against life-threatening diseases due to lack of vaccines or late administration. Almost all vaccines work through induction of serum or mucosal antibodies, especially in young infants where the lack of previous antigen exposure limits the effectiveness of T cell responses. Cellular immunity is also required for protection against disseminated disease and recovery from measles and smallpox. Effective neonatal vaccination would be ideal especially for less privileged infants, for whom birth is often the only contact with health care systems. Neonatal vaccination therefore has the potential to improve vaccine coverage and confer protection before initial exposure to vaccine-preventable viral and bacterial infections. Alternative, indirect strategies include vaccination of the pregnant mother and/or other family members so as to “cocoon” the neonate against exposure to pathogens, but these strategies have shortcomings.