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Prematurity and immunisation — DCH MCQ

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ModerateImmunisationPrematurity and immunisationDCH

An infant born at 30 weeks’ gestation is now 8 weeks old and remains on the neonatal unit for feeding support. The infant is clinically stable, with no current acute illness. The parents ask whether routine vaccinations should be postponed until the expected date of delivery. What is the most appropriate advice?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Give routine vaccinations according to chronological age

Explanation lettering: E = shown as A · A = shown as C · C = shown as D · D = shown as E

The correct answer is B. Premature infants receive routine immunisations according to chronological age, measured from the date of birth, rather than corrected age or the expected date of delivery. This clinically stable infant is therefore due routine vaccinations at 8 weeks, even while still in hospital, using standard doses. Delaying until discharge (A) may leave a vulnerable infant unprotected. Vaccine doses are not reduced because of prematurity (C), and corrected age is not used for routine vaccine timing (D). Pneumococcal vaccination is not avoided or deferred solely because an infant was premature (E). Some very premature infants may require appropriate observation for post-vaccination apnoea, but this affects monitoring rather than the vaccination schedule.

Reference: UK Health Security Agency. Immunisation against infectious disease: Green Book, Chapter 11, section 'Premature infants'. 30 March 2026. https://assets.publishing.service.gov.uk/media/69cbb5ef8017673ffec0f313/Green-book-chapter-11-immunisation-schedules_30_03_26.pdf