Vaccinations in the newborn

Neonatal immunisation includes vaccination in the first 4 weeks of life (Neonatal period) as well as in high-risk preterm infants in the first few months (until 44 weeks corrected gestational age). Neonates have an immature immune system, which renders them highly susceptible to life-threatening infections. This highlights the importance of vaccination in this vulnerable population; however, at the same time also making it challenging because of their inability to generate a protective immune response. Other challenges include interference from maternal antibodies and excessive skewing towards T Helper Cell Type 2 (Th2) immunity. Despite these challenges, several vaccines have been developed and proven safe and effective at birth. Presently, there are 3 vaccines Hepatitis B vaccine, Bacillus Calmette-Guerine (BCG) and Oral Polio vaccine (OPV) widely used in neonates, which provides evidence that certain antigen-adjuvant combinations can elicit protective neonatal responses. This review focusses on current vaccinations in neonates, including preterm infants and highlights some novel approaches to enhance neonatal vaccination. (c) 2020 Published by Elsevier Ltd.