TY  - JOUR
A1  - Fortmann, Ingmar
A1  - Dammann, Marie-Theres
A1  - Humberg, Alexander
A1  - Siller, Bastian
A1  - Stichtenoth, Guido
A1  - Engels, Geraldine
A1  - Marißen, Janina
A1  - Faust, Kirstin
A1  - Hanke, Kathrin
A1  - Goedicke-Fritz, Sybelle
A1  - Derouet, Christoph
A1  - Meyer, Sascha
A1  - Stutz, Regine
A1  - Kaiser, Elisabeth
A1  - Herting, Egbert
A1  - Göpel, Wolfgang
A1  - Härtel, Christoph
A1  - Zemlin, Michael
T1  - Five year follow up of extremely low gestational age infants after timely or delayed administration of routine vaccinations
JF  - Vaccines
N2  - This study is aimed at detecting the rate of untimely immunization in a large cohort of extremely low gestational age neonates (ELGANs) of the German Neonatal Network (GNN) and at addressing risk factors for delayed vaccination and associated long-term consequences. We performed an observational study of the GNN between 1st January 2010 and 31st December 2019. The immunization status for the hexavalent and pneumococcal immunization was evaluated in n = 8401 preterm infants <29 weeks of gestation. Univariate analysis and logistic/linear regression models were used to identify risk factors for vaccination delay and outcomes at a 5-year follow-up. In our cohort n = 824 (9.8%) ELGANs did not receive a timely first immunization with the hexavalent and pneumococcal vaccine. Risk factors for delayed vaccination were SGA status (18.1% vs. 13.5%; OR 1.3; 95% CI: 1.1–1.7), impaired growth and surrogates for complicated clinical courses (i.e., need for inotropes, necrotizing enterocolitis). At 5 years of age, timely immunized children had a lower risk of bronchitis (episodes within last year: 27.3% vs. 37.7%; OR 0.60, 95% CI: 0.42–0.86) but spirometry measures were unaffected. In conclusion, a significant proportion of ELGANs are untimely immunized, specifically those with increased vulnerability, even though they might particularly benefit from the immune-promoting effects of a timely vaccination.
KW  - immunization
KW  - prematurity
KW  - trained immunity
KW  - long-term outcome
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239592
SN  - 2076-393X
VL  - 9
IS  - 5
ER  - 
TY  - JOUR
A1  - Fortmann, Mats Ingmar
A1  - Dirks, Johannes
A1  - Goedicke-Fritz, Sybelle
A1  - Liese, Johannes
A1  - Zemlin, Michael
A1  - Morbach, Henner
A1  - Härtel, Christoph
T1  - Immunization of preterm infants: current evidence and future strategies to individualized approaches
JF  - Seminars in Immunopathology
N2  - Preterm infants are at particularly high risk for infectious diseases. As this vulnerability extends beyond the neonatal period into childhood and adolescence, preterm infants benefit greatly from infection-preventive measures such as immunizations. However, there is an ongoing discussion about vaccine safety and efficacy due to preterm infants’ distinct immunological features. A significant proportion of infants remains un- or under-immunized when discharged from primary hospital stay. Educating health care professionals and parents, promoting maternal immunization and evaluating the potential of new vaccination tools are important means to reduce the overall burden from infectious diseases in preterm infants. In this narrative review, we summarize the current knowledge about vaccinations in premature infants. We discuss the specificities of early life immunity and memory function, including the role of polyreactive B cells, restricted B cell receptor diversity and heterologous immunity mediated by a cross-reactive T cell repertoire. Recently, mechanistic studies indicated that tissue-resident memory (Trm) cell populations including T cells, B cells and macrophages are already established in the fetus. Their role in human early life immunity, however, is not yet understood. Tissue-resident memory T cells, for example, are diminished in airway tissues in neonates as compared to older children or adults. Hence, the ability to make specific recall responses after secondary infectious stimulus is hampered, a phenomenon that is transcriptionally regulated by enhanced expression of T-bet. Furthermore, the microbiome establishment is a dominant factor to shape resident immunity at mucosal surfaces, but it is often disturbed in the context of preterm birth. The proposed function of Trm T cells to remember benign interactions with the microbiome might therefore be reduced which would contribute to an increased risk for sustained inflammation. An improved understanding of Trm interactions may determine novel targets of vaccination, e.g., modulation of T-bet responses and facilitate more individualized approaches to protect preterm babies in the future.
KW  - preterm infants
KW  - immunization
KW  - vaccination
KW  - safety
KW  - mechanisms
KW  - resident memory T cells
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324261
VL  - 44
IS  - 6
ER  -