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   Apnea after Vaccination Autoimmune diseases

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Apnea After Immunization Predictable in Some Hospitalized Neonates

By David Douglas

NEW YORK (Reuters Health) Mar 12 - Multiple factors, including severity of illness, predict apnea following immunization in hospitalized infants, researchers report in the March issue of Pediatrics.

"This study," lead investigator Dr. Nicola P. Klein told Reuters Health, "can help physicians identify hospitalized premature infants in neonatal intensive care units who are at risk for developing apnea after receiving routine immunizations."

Dr. Klein of Kaiser Permanente, Oakland, California and colleagues, using data from that organization, identified more than 16,000 infants who were admitted to the NICU for at least 53 days. In all, 497 infants received 1 or more vaccines and met other entry criteria.

All of the 27 infants who had apnea before immunization, and all but three of the 65 infants who had post-immunization apnea, had gestational ages of less than 31 weeks.

The most important predictor of apnea after immunization was having apnea before immunization, but there were also associations with a higher 12-hour Score for Neonatal Acute Physiology II and an age that was less than the mean for the cohort (67 days).

Forty-nine infants without pre-immunization apnea and with one or more apnea predictors were discharged within 48 hours of immunization. Of these, two were subsequently readmitted because of apnea.

Overall, concluded Dr. Klein, "focusing on these at-risk infants could result in improved vaccine safety because they would likely remain hospitalized for monitoring after immunization."

Pediatrics 2008;12:463-469.