# Standardized vaccination practices for preterm infants: Egyptian experts’ consensus

## TL;DR

Egyptian experts developed standardized vaccination guidelines for preterm infants to improve immunization and reduce infection risks.

## Contribution

The paper presents a consensus-based framework for preterm infant vaccination in Egypt, addressing gaps in evidence and practice.

## Key findings

- A modified Delphi approach was used to formulate 59 evidence-based vaccination statements for preterm infants.
- Consensus was reached on 54 statements in the first round, with five additional statements achieving agreement after a second round.
- The guidelines emphasize timely immunization and highlight areas needing further research.

## Abstract

Preterm birth has become increasingly common over the past several decades. The underdeveloped immune systems place preterm infants at an increased risk of infections, often vaccine-preventable, compared to full-term infants. Despite the importance of immunizing preterm infants, research on vaccine safety, immunogenicity, and effectiveness in this population remains limited. This consensus article seeks to provide clear, evidence-based recommendations to improve vaccine coverage and timely immunization in preterm infants in Egypt.

A modified Delphi consensus approach was employed to develop evidence-based recommendations for preterm infant vaccination in Egypt. A panel of 18 experts, including pediatricians, neonatologists, and a pharmacist participated. The process covered 15 key vaccination topics, with 59 statements formulated based on a comprehensive literature review. A 5-point Likert scale was used to evaluate the statements, with ≥ 70% agreement threshold for consensus. Statements not meeting this threshold were revised and subjected to a second voting round. Final recommendations were established based on the achieved consensus.

Our consensus included 59 statements. In the first round of voting, 63 statements were evaluated, with the panel reaching a consensus on 54 statements. Nine statements fell below the 70% agreement threshold and required a second round of voting. A second round was conducted, including these nine statements along with one newly added statement. Ultimately, five statements achieved consensus, while five were removed.

Establishing preterm vaccination guidelines is important for reducing mortality and morbidity in this high-risk population, especially in Egypt. This consensus emphasizes the need for timely immunization to minimize the risk of infections associated with delayed vaccination. Additionally, it identifies several areas requiring further research, ensuring that future updates can continue to refine and enhance immunization strategies for preterm infants.

Not applicable.

The online version contains supplementary material available at 10.1186/s12879-025-12243-0.