Immunogenicity of recombinant hepatitis B vaccine: comparison of two different vaccination schedules

Abstract

BackgroundNeonatal immunization with hepatitis B (HB) vaccine induces protective levels of antibody (anti-HBs ≥10 IU/L) in a majority of vaccines. However, the duration of protection after HB vaccination in infants is unknown. A smaller proportion of children vaccinated beginning at birth with three doses of HB vaccine were found to have protective titers 5–10 years after initial vaccination. Long-term efficacy of HB vaccine depends mainly on peak antibody levels after vaccination, and subjects were observed to have lower levels of antibodies if they received the first dose of vaccine immediately after birth. The aim of our study was to compare the immunogenicity of two different HB vaccine schedules in infants born to HB surface antigen-negative mothers.MethodsAnti-HBs titers in infants vaccinated with two different schedules were compared. Infants were vaccinated at 0, 2, and 9 months (group 1) or at 2, 4, and 9 months (group 2). In total, 267 blood samples were analyzed at a mean of 14.20 ± 2.39 months after the third vaccine dose. Sera were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc) using commercial enzyme immunoassay kits.ResultsThe geometric mean titers for anti-HBs were 95.00 and 379.51 IU/L and the rates of anti-HBs more than ≥100 IU/L were 57.7 and 94.9% in group 1 and 2 infants, respectively.ConclusionDelaying the first dose of the HB vaccine until 2 months after birth produces a higher immune response and can provide longer term protection.

Maternal anti‐HBVs suppress the immune response of infants to hepatitis B vaccine

“…Delaying the first dose of the HBV vaccine may increase the anti-HBVs response rate. Aglad-ioglu et al 27 reported that infants with HBVsAg-negative mothers vaccinated following the 2-4-9 (age in months) schedule produces a higher immune response compare to the 0-1-6 (age in months) schedule and can provide longer term protection. Other vaccines, such as the HAV vaccine, the first dose of which was not given at birth, also achieved good effects in protecting infants.…”

Immunisation after hepatitis B polyvalent vaccination among children in South Kivu Province, Democratic Republic of the Congo

“…[8] It must, however, be noted that no substantial difference in the response rate was reported in some studies comparing the immune response to hepatitis B vaccination given at birth or 4 or 6 weeks after delivery. [11,19,33,34]…”

Hepatitis B in the United States: ongoing missed opportunities for hepatitis B vaccination, evidence from the Behavioral Risk Factor Surveillance Survey, 2007

“…The increased likelihood of hepatitis B vaccine receipt observed among adults 18-33 years of age likely reflects policy amendments made in the early 1990s, which universalized hepatitis B vaccination at birth in the USA and initiated catch-up vaccination programs for children and adolescents. Past studies, both domestically in Alaska as well as internationally, have documented similar distributions in hepatitis B vaccine receipt, where younger adults were more likely to have been vaccinated due to catch-up vaccination programs than older adults [14,15]. The associations between sex and relationship status may reflect previously documented increased utilization of health services by women and by those in relationships [16,17].…”