Hepatitis B Vaccination and Preterm Infants

Canho, R. del; Grosheide, P.M.; Gerards, L. J.; Heijtink, R. A.; Schalm, Solko W.

doi:10.1097/00006454-199305000-00012

Cited by 35 publications

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“…14 The authors suggested that there is no need to delay vaccination in preterm infants with birthweights < 2000 g. 14 However, their conclusion was not very convincing because in that study a total of 46 preterm infants had received 11 different combinations of diVerent types of vaccine, diVerent doses of vaccine, and diVerent vaccination schedules. 14 The data reported by Lau et al have clearly shown that preterm infants with birthweights <1750 g respond poorly to hepatitis B vaccines if the vaccination is started at birth. 11 In Lau et al's study, a group of preterm infants with birthweights of <1750 g received the first dose of 10 µg Engerix-B when they weighed >2000 g. The immune responses of these preterm infants were not as competent as those of term infants.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14] The reasons for these discrepancies may be clarified by carefully reviewing the data. In a study of preterm infants in Thailand, three 10 µg doses of Engerix-B were given at birth, 1 month, and 6 months of age.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have revealed that the antibody response to hepatitis B vaccines may be lower in premature infants given the vaccines beginning at birth than if the initial dose is delayed until they are older or weigh more than 2000 g. [11][12][13] However, in another study, starting hepatitis B vaccination at birth was reported to elicit a similar antibody response in preterm and term infants. 14 As a result it has been diYcult to integrate these data and to establish an optimal schedule, because the studies enrolled a limited number of cases, 12 13 used diVerent vaccination schedules, 14 and did not include preterm infants with birthweights above 2000 g. 11 According to current recommendations by the Advisory Committee for Immunization Practice of the US Public Health Service, preterm infants with birthweights >2000 g receive recombinant hepatitis B vaccines according to the same schedule as that given for full term infants. For preterm infants with birthweights < 2000 g, the first dose of vaccine is delayed until just before hospital discharge if the infant weighs 2 kg or more, or until about 2 months of age when other routine immunisations are given.…”

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confidence: 99%

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Hepatitis b vaccination in preterm infants

1998

Indian J Pediatr

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Aim-To investigate the immunogenicity and safety of existing recommendations for hepatitis B vaccination in preterm infants. Methods-Recombinant hepatitis B vaccine (H-B-VAX II, 5 µg per dose) was given to 85 preterm infants divided into two groups, using two diVerent schedules. Forty four group A infants with birthweights of < 2000 g received three doses at 1, 2, and 7 months of age. Forty one group B infants with birthweights of >2000 g received three doses at 0, 1, and 6 months of age. Results-After vaccination, 42 infants from group A (95%) and 37 infants from group B (90%) developed protective levels of antibody. The final seropositive rate and the geometric mean concentration of hepatitis B surface antibody between the two groups were not significantly diVerent. The immune response of preterm infants to hepatitis B vaccines was similar to that of term infants in a previous study. Conclusions-Preterm infants can be given hepatitis B vaccines using one of the above two diVerent schedules, at a cutoV birthweight of 2000 g. (Arch Dis Child 1997;77:F135-F138)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Hepatitis b vaccination in preterm infants

1998

Indian J Pediatr

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“…However, the methodological features of this and other studies that have returned similar results, should be observed. In general, these studies included NB from a wide gestational age and birth-weight range, with the majority of the members of the sample groups having gestational ages close to 36 weeks or birth weights close to 2,000 g. 5,6 In contrast, other studies that have performed early vaccination on larger numbers of preterm NB whose birth weights were < 1,500 g or gestational ages < 32 weeks, 2,3,7-9 including a study we performed of Brazilian children, 10 have identified significantly lower levels of immunogenicity among preterm NB after the complete course of vaccination was completed (60-77%) than among full term NB (98-100%). While the study made by Sadeck & Ramos was not designed for this end, it too identified a reduced frequency of post-vaccination protective antibody levels within the subgroup of preterm NB born weighing less than 1,500 g. 4 What are the implications of reduced vaccination immunogenicity among preterm NB born at less than < 1,500-1,800 g and/or with a gestational age < 32-34 weeks for infant VHB infection prevention?…”

Section: See Related Article On Page 113mentioning

confidence: 99%

Imunogenicidade da vacina contra hepatite B iniciada precocemente em pré-termos: implicações para a prevenção

Mussi-Pinhata¹

2004

J. Pediatr. (Rio J.)

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Infections by the hepatitis B virus (VHB) that occur during infancy, acquired from a mother carrying the virus, account for 40% of all infections and are of great clinical and epidemiological relevance worldwide. Despite the acute infection being symptomatic in less than 10% of children, the development of a chronic infection and its consequences, after an acute infection, is inversely proportional to age of exposure. The risk of a chronic infection is at a maximum (70-90%) in children who acquire an infection during the perinatal period and it is these children that constitute the main virus reservoir for spreading the infection to other individuals.The hepatitis B virus can be transmitted from mother to child during pregnancy. However, perinatal exposure to maternal blood and genital secretions is the most efficient means of transmission and can affect between 65 and 93% of newborn babies (NB) whose mothers are infected and carry the e antigen (HBeAg), while the risk of infection (0 to 19%) is lower in the absence of this marker. Even if children do not acquire a perinatal infection, they remain at risk of acquiring an infection by horizontal transmission by means of close contact with their mothers.The measures available for perinatal VHB transmission prevention are highly effective. Data originating in Asian countries, with elevated endemicity of infection, indicate that full term NB given a combination of human hepatitis B hyperimmune immunoglobulin (HGIG) and the VHB vaccine soon after birth, present an effective level of protection of between 85 and 95%, even when the mother is HBe antigen positive and does not have anti-HBe antibodies. Even vaccination regimen using VHB vaccine in isolation during the perinatal period prevent 70 to 85% of vertical transmission cases, depending on the frequency of HBeAg markers in the population and also confer protection against post-natal infection. 1 The protective efficacy of hepatitis B vaccination is associated with the development of anti-HBs antibody

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“…Doubts persist, however, over the vaccine immunoresponse from premature newborns (PN), when vaccination is started on the first day of life. [6][7][8][9][10][11][12][13] It is not yet clear whether the response to immunization is determined by birth weight (BW), gestational age (GA), clinical conditions, age at start of vaccination or the number of doses administered. Even the most recent research has returned conflicting data.…”

Section: Introductionmentioning

confidence: 99%

Resposta imune à vacinação contra hepatite B em recém-nascidos pré-termo, iniciada no primeiro dia de vida

Sadeck¹,

Ramos²

2004

J. Pediatr. (Rio J.)

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Objective: To investigate the immune response of preterm infants to hepatitis B vaccination.Methods: Three doses of recombinant hepatitis B vaccine (5 µg dose) were administered to 35 preterm and 21 full-term infants within 24 hours after birth and at one and six months of postnatal age.Results: A protective antibody response (anti-HB > 10 mUI/mL) was observed three months after the last dose in 92.6% and 100% of preterm and full-term infants (p > 0.05), respectively. Newborns with gestational age below 34 weeks presented lower antibody responses in all three periods. However, gestational age was not important to determine the antibody response in the three periods analyzed. When antibody response was analyzed in terms of birth weight, it was observed that a protective response was present in 75 and 100% of newborns with birth weight < 1,500 g and > 1,500 g, respectively. Birth weight was shown to be a relevant factor in determining a protective antibody response at six months of postnatal age. Nonresponders received a fourth vaccine dose and an adequate antibody response was obtained in 100%. Conclusion:The antibody response of preterm infants was similar to that of term newborns. Hepatitis B vaccination can be initiated on the first day of life in preterm newborns, following the same scheme recommended for term newborns. However, in preterm infants with birth weight less than or equal to 1,500 g, whose antibody response is lower, anti-HB titers should be monitored at nine months of age, or a four-dose vaccination scheme should be provided, with doses on the first day of postnatal life and one, six and nine months later.

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Hepatitis B Vaccination and Preterm Infants

Cited by 35 publications

References 0 publications

Hepatitis b vaccination in preterm infants

Hepatitis b vaccination in preterm infants

Imunogenicidade da vacina contra hepatite B iniciada precocemente em pré-termos: implicações para a prevenção

Resposta imune à vacinação contra hepatite B em recém-nascidos pré-termo, iniciada no primeiro dia de vida

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