{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T21:15:54Z","timestamp":1775855754728,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Ministry for Education and Research","award":["BMBF 01ER0805"],"award-info":[{"award-number":["BMBF 01ER0805"]}]},{"name":"German Ministry for Education and Research","award":["BMBF 01ER1501"],"award-info":[{"award-number":["BMBF 01ER1501"]}]},{"name":"German Ministry for Education and Research","award":["LACS02-2024"],"award-info":[{"award-number":["LACS02-2024"]}]},{"name":"Section of Medicine, University of L\u00fcbeck","award":["BMBF 01ER0805"],"award-info":[{"award-number":["BMBF 01ER0805"]}]},{"name":"Section of Medicine, University of L\u00fcbeck","award":["BMBF 01ER1501"],"award-info":[{"award-number":["BMBF 01ER1501"]}]},{"name":"Section of Medicine, University of L\u00fcbeck","award":["LACS02-2024"],"award-info":[{"award-number":["LACS02-2024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Very-low-birth-weight infants (VLBWIs; birth weight &lt; 1500 g) are at an increased risk of complicated influenza infection, which frequently includes pneumonia, encephalitis or even death. Data on influenza immunization and its outcome in VLBWIs are scarce. This study aimed to provide epidemiological data on influenza immunization for German VLBWIs and hypothesized that immunization would protect VLBWIs from infection-mediated neurodevelopmental impairment and preserves lung function at early school age. Methods: In this observational population-based German Neonatal Network (GNN) study, infants born between 2009 and 2015 were invited to partake in a 6-year follow-up investigation including lung function and developmental testing. Uni- and multivariate analyses were performed to evaluate the clinical characteristics and outcomes of influenza-immunized VLBWIs compared to non-immunized VLBWIs. Results: Influenza immunization was performed in 871 out of the 3358 VLBWIs (26%) with six-year follow-up. Immunized infants were characterized by a low gestational age and higher rates of morbidity, particularly bronchopulmonary dysplasia. Although early immunization showed no safety signals and had protective effects on the long-term risk of bronchitis (OR: 0.2; CI: 0.1\u20130.6; p = 0.002), most VLBWIs (88.0%) were unimmunized in their first influenza season. Conclusions: Influenza immunization was not associated with improved lung function (forced expiratory volume in one second and forced vital capacity) or a better neurocognitive outcome (intelligence quotient and strengths and difficulties questionnaire) at early school age. In Germany, only one quarter of 6-year-old VLBWIs were immunized against influenza, particularly those born &lt;28 gestational weeks and\/or BPD. Specific influenza immunization guidelines that define evidence-based recommendations are needed for this vulnerable group.<\/jats:p>","DOI":"10.3390\/vaccines13010042","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T03:38:41Z","timestamp":1736221121000},"page":"42","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Influenza Immunization in Very-Low-Birth-Weight Infants: Epidemiology and Long-Term Outcomes"],"prefix":"10.3390","volume":"13","author":[{"given":"Marie-Theres","family":"Dammann","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3200-5373","authenticated-orcid":false,"given":"Hannah","family":"Kraft","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1769-1859","authenticated-orcid":false,"given":"Guido","family":"Stichtenoth","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrin","family":"Hanke","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-7419","authenticated-orcid":false,"given":"Michael","family":"Zemlin","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Neonatology, Saarland University, 66123 Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2433-707X","authenticated-orcid":false,"given":"Janina","family":"Soler Wenglein","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Protestant Hospital of the Bethel Foundation, Medical School and University Medical Center East Westphalia-Lippe, Bielefeld University, 33617 Bielefeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabell","family":"Ricklefs","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1830-4622","authenticated-orcid":false,"given":"Alexander","family":"Herz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Humberg","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics, University Children\u2019s Hospital M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothee","family":"Viemann","sequence":"additional","affiliation":[{"name":"Center for Infection Research, University of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Department of Pediatrics, University of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, 30625 Hannover, Germany"},{"name":"Airway Research Center North, German Center of Lung Research (DZL), 23562 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0873-3631","authenticated-orcid":false,"given":"Geraldine","family":"Engels","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias Volkmar","family":"Kopp","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"},{"name":"Airway Research Center North, German Center of Lung Research (DZL), 23562 L\u00fcbeck, Germany"},{"name":"Department of Paediatric Respiratory Medicine, Inselspital, University Children`s Hospital of Bern, 3008 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Folke","family":"Brinkmann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"},{"name":"Airway Research Center North, German Center of Lung Research (DZL), 23562 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2579-5546","authenticated-orcid":false,"given":"Carsten","family":"Fortmann-Grote","sequence":"additional","affiliation":[{"name":"Scientific Computing Unit, Department of Microbial Population Biology, Max-Plank-Institute for Evolutionary Biology, 24306 Pl\u00f6n, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"G\u00f6pel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7189-879X","authenticated-orcid":false,"given":"Egbert","family":"Herting","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"H\u00e4rtel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1676-8340","authenticated-orcid":false,"given":"Ingmar","family":"Fortmann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of L\u00fcbeck, 23538 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the German Neonatal Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s12519-015-0055-x","article-title":"Prematurity and the burden of 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