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Safety & Prevention

Immunizations For Preterm Babies

​Some parents of preterm and low birth weight babies are concerned about immunizing their newborns according to the standard schedule created by the American Academy of Pediatrics (AAP) and other medical organizations. Their main worry is whether the recommendations were made with full-term, normal weight babies in mind and whether the same guidelines apply to their own newborns. Parents may think that their newborns are just too fragile to be vaccinated because of low birth weight and possible health problems that came with their baby's preterm birth.

Your pediatrician will tell you that all of these babies should be given the routinely recommended childhood vaccinations. They should get every immunization on the standard schedule when they reach the ages at which these shots are normally given to all children.

If you're uncertain, keep in mind:

  • If preterm babies get the infections that vaccines can prevent, they have a greater chance of having disease-related problems. See Weighing the Risks and Benefits.

  • All of the available vaccines are safe when given to preterm and low birth weight babies.

  • Any side effects associated with the vaccines are similar in both full-term and preterm babies.

The hepatitis B vaccine deserves special mention.

Newborns should receive their first dose of hepatitis B vaccine within the first 24 hours of birth. Newborns who for a medical or other reason did not get the vaccine at birth should get their first dose as soon as possible, and complete all 3 doses at the recommended intervals. 

If a pregnant woman tests positive for HBV during routine prenatal screening or at the time of delivery, her child must receive the first dose of hepatitis B vaccine within 12 hours of birth. The second dose should be given at 1 month of age, and the final dose by 6 months of age. 

Note: The AAP recommends that all medically stable preterm babies with a minimum birth weight of 2000 grams (about 4 lbs., 6 oz.) be treated like full-term babies and receive the first dose of the hepatitis B immunization according to the recommended childhood immunization schedule. If birth weight is less than 2000 g, the AAP recommends administering the hepatitis B vaccine at one month of age or at the time of discharge from the hospital – whichever comes first.​

Additional Information from

Last Updated
Committee on Infectious Diseases (Copyright © 2017 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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