Delayed Vaccination in Preterm and Low-Birth-Weight Newborns: Predictive Factors and the Impact of Healthcare Professionals' Knowledge, Attitudes, and Practices.

Background Preterm and low-birth-weight newborns are at increased risk of vaccine-preventable infections due to immunological immaturity and reduced transplacental transfer of maternal antibodies. Despite recommendations advocating vaccination according to chronological age, delays in immunization remain frequent in this population, often influenced by healthcare professionals' knowledge, attitudes, and practices. Objective To assess healthcare professionals' knowledge, attitudes, and practices regarding the vaccination of preterm and low-birth-weight newborns and to identify professional factors associated with delayed vaccination. Methods A descriptive and analytical cross-sectional study was conducted in July 2025 among 104 healthcare professionals involved in neonatal care and immunization. Data were collected using a structured, anonymous, self-administered questionnaire assessing knowledge, attitudes, and practices. Statistical analysis was performed using appropriate tests, with a significance level set at p < 0.05. Results A total of 104 healthcare professionals participated in the study, of whom 66% had already vaccinated or supervised the vaccination of preterm or low-birth-weight newborns. Significant variability in knowledge and practices was observed across professional categories, particularly between physicians and paramedical staff. Despite prior experience, important knowledge gaps persisted. Four factors were significantly associated with delayed vaccination (p < 0.05): lack of professional training (85%), the belief that prematurity constitutes a contraindication to vaccination (86%), the requirement for a birth weight above 3000 g before initiating vaccination (47%), and parental hesitancy (63%). Conclusion Healthcare professionals' knowledge gaps and inappropriate practices are significantly associated with delayed vaccination in preterm and low-birth-weight newborns. Strengthening targeted training programs and implementing standardized guidelines are essential to improve vaccination practices and ensure optimal protection of this high-risk population.