Reuters Health Information: REFILE-Early childhood hep B vaccine gives long-term protection
REFILE-Early childhood hep B vaccine gives long-term protection
Last Updated: 2014-07-24
(Adds "pertussis" in parenthetical phrase in para 3, and in
para 11, replaces the word "randomized" with "reassigned")
By Lorraine L. Janeczko
NEW YORK (Reuters Health) - Immunity to hepatitis B after
primary immunization in early childhood gives long-term
protection, a new study suggests.
In children primed at 3, 5 and 11 months of age,
immunization with conjugate or monovalent vaccines induced
long-lasting immune memory against HBV, and was well tolerated,
the researchers report online June 22 in Vaccine.
Antibody persistence and immune memory were similar,
suggesting that the protection given by the combined
DTPa-HBV-IPV/Hib vaccine (hexavalent
diphtheria-tetanus-pertussis- hepatitis B-inactivated
poliomyelitis - Haemophilus influenzae type b) and monovalent
HBV vaccines is likely to last as long, they write.
"These findings surprised us positively and confirmed that
hepatitis B vaccines are very well tolerated by children. We
found that it is not the necessary to change our immunization
schedule regarding the administration of the HBV component of
the combined vaccine," wrote Dr. Maria Avdicova, of the Regional
Authority of Public Health in Banska Bystrica, Slovakia, by
email to Reuters Health.
"Vaccination against HBV is an example of a very positive
story in many countries, including my own," although the
schedule may vary by country, she wrote.
Dr. Walter Orenstein, of the Emory University School of
Medicine and the Emory Vaccine Center, wrote in an email, "The
study shows that immunity to hepatitis B following a primary
series in early childhood is long term and the data do not
support a need for boosters with increasing time since
vaccination. A primary series alone appears adequate to induce
Doctors should keep doing what they've been doing, he said.
To assess the long-term HBV antibody persistence 10 to 11
years after primary vaccination in infancy, Dr. Avdicova and
colleagues looked at a vaccination trial conducted between 1998
All 312 children who took part in the earlier study were
invited to participate in the new phase 4 open, follow-up
challenge trial in 2010, at 12 centers in Slovakia.
Children were ineligible if they had received HBV
vaccination since completing the initial vaccination; if they
had a history of HBV infection; if they had received
immunoglobulin or blood products within the previous three
months or planned to receive them during the study; if they were
immunosuppressed; or if they had received or planned to receive
any other vaccine within 30 days before or after the HBV dose.
In the earlier trial, the children had received three doses
of either DTPa-HBV-IPV/Hib, or DTPa-IPV/Hib + HBV, at 3, 5, and
11 months of age, and in this new study they were reassigned to
their original group. All 185 participants received one
challenge dose intramuscularly in the non-dominant deltoid.
Blood samples were collected before the challenge dose and one
Overall, 48.4% in the DTPa-HBV-IPV/Hib group and 58.4% in
the DTPa-IPV/Hib + HBV group showed persisting anti-HBs antibody
concentrations 10 mIU/ml.
After the HBV challenge dose, the children with anti-HBs
100 mIU/ml increased from 14.7% to 93.6% in the
DTPa-HBV-IPV/Hib group and from 19.1% to 94.4% in the
DTPa-IPV/Hib + HBV group.
In both groups, antibody against hepatitis B surface antigen
(anti-HBs) geometric mean antibody concentration (GMC) increased
at least 187-fold. An anamnestic response (4-fold increase in
initially seropositive subjects, or anti-HBs concentration 10
mIU/ml in initially seronegative subjects) was seen in 96.8% and
96.6% of children in the DTPa-HBV-IPV/Hib and DTPa-IPV/Hib + HBV
There were no serious adverse events related to the
challenge vaccination, the authors said.
"These findings reinforce the use of a 3, 5, and 12 month
schedule used by a number of countries," wrote Dr. Orenstein,
who was not involved in the study.
"Hepatitis B vaccine is important to provide to all infants.
In the US, the primary schedule consists of three doses,
administered at birth, 1 to 2 months of age, and 6 to 18 months
of age," he wrote.
"The vaccine not only prevents clinical hepatitis and the
liver damage that results from acute infection but also prevents
hepatitis B induced liver cancer. In fact, hepatitis B vaccine
is our first anti-cancer vaccine, with human papilloma virus
(HPV) our second anti-cancer vaccine," he wrote.
In a separate study reported online July 2 in Vaccine, Dr.
Carol Yuet Sheung Yuen and colleagues at the Li Ka Shing Faculty
of Medicine of the University of Hong Kong in Pokfulam,
conducted a detailed literature search of articles related to
the uptake of influenza vaccination during pregnancy, and found
it suboptimal, ranging from 1.7% to 88.4% for seasonal
influenza, and from 6.2% to 85.7% for A/H1N1 pandemic influenza.
Many pregnant women were unaware that they were at high risk
for influenza and its complications during pregnancy,
underestimated the threat of influenza to themselves and their
fetus, and were concerned about the safety and efficacy of
having the influenza vaccine during pregnancy.
Negative media reports contributed to the perception that
influenza vaccination during pregnancy was risky and most health
care providers did not recommend the vaccine to their pregnant
The authors advise health care providers to recommend the
vaccines and provide access to them.
SOURCES: http://bit.ly/1l3FKFB and http://bit.ly/1yryuf4