Do premature babies follow the normal vaccine schedule?

Actual age, not corrected age

By the time we reached vaccines we had thoroughly learned to count from the due date. Feeding, milestones, sleep expectations, how much she should weigh — all corrected age.

So it was genuinely surprising to find that routine vaccines generally go by actual age, from her birthday. They don't adjust the schedule for prematurity in the way everything else is adjusted.

Hers came as a set at one appointment, including one given by mouth rather than by injection. That sounds like a lot and it is standard.

We found it worth knowing which were injections and which was oral, because the oral one can loosen nappies for a few days afterwards and we would otherwise have been counting that as a separate problem.

The day afterwards

Ours was crying constantly within hours, had a raised temperature, and was miserable for a day. That is the usual shape and it was much easier because we had asked what to expect.

What helped: clearing the following day completely, offering smaller feeds more often, and having already asked whether pain relief was appropriate and what the dose was for her weight. Looking that up at 10pm with a crying baby is the version to avoid.

This was the question we got most tangled in. If a mother has an RSV vaccine during pregnancy, does the baby still need protection directly?

They are not the same intervention. A vaccine given in pregnancy works by passing antibodies across to the baby before birth, and a baby born early has had less time to receive them. Protection given directly to a baby afterwards is a different product, with its own eligibility criteria that usually depend on gestational age, birth weight, lung problems and the season.

Ask about RSV early

One genuinely practical thing. If you are collecting a vaccine from a pharmacy yourself and taking it to the doctor, it has a temperature range and a time limit.

Ask the pharmacy for the specific window and how to transport it — a cool bag, how long it can be out, whether a car with air conditioning counts. Don't estimate. A vaccine that has been warm for too long may be no good, and nobody can tell by looking at it.