Hepatitis B vaccine administered to children and adolescents at yearly intervals

被引:36
|
作者
Halsey, NA
Moulton, LH
O'Donovan, JC
Walcher, JR
Thoms, ML
Margolis, HS
Krause, DS
机构
[1] Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, Baltimore, MD 21205 USA
[2] Drs ODonovan Ahluwalia & Fertsch, Baltimore, MD USA
[3] Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Hepatitis Branch, Atlanta, GA USA
[4] SmithKline Beecham Pharmaceut, Collegeville, PA USA
关键词
vaccine; hepatitis B; hepatitis B vaccine; antigen; dose; schedule; immunization; adolescent;
D O I
10.1542/peds.103.6.1243
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective. Hepatitis B vaccines are usually administered on a schedule of 0, 1 to 2, and 6 months. Longer intervals between the second and third doses have been studied, but the effectiveness of hepatitis B vaccine administered at intervals of >2 months between the first and second doses have not been studied. Our objective was to compare the antibody response in recipients of Engerix-B hepatitis B vaccine administered at 12-month intervals to the response to vaccine administered at 0, 1-, and 6-month intervals. Methods. A total of 389 children, 5 through 16 years of age, were randomized to receive Engerix-B (10 mg) at a schedule of either 0-, 1-, and 6-month intervals or 0-, 12-, and 24-month intervals. Blood was drawn before and 1 month after the third dose. Results. Immediately before the third dose of vaccine, 92.3% of children who received vaccine on the 0-, 1-, and 6-month schedule and 88.8% of children who received the 0-, 12-, and 24-month schedule had antibody to hepatitis B surface (anti-HBs) antigen concentrations greater than or equal to 10 mIU/mL. Of the children in the 0-, 1-, and 6-month schedule, 95% received the third dose according to protocol versus 90% of those in the 0-, 12-, 24-month schedule. The geometric mean anti-HBs concentration just before the third dose for recipients of the 0-, Ii and 6-month schedule (117.9 mIU/mL) was somewhat lower than that for the children who had received vaccine on the 0-, 12-, and 24-month schedule (162.1 mIU/mL). One month after the third dose, >98% of all children had anti-HBs concentrations greater than or equal to 10 mIU/mL and high geometric mean antibody concentrations were observed in both groups: 5687 mIU/mL for children on the 0-, 1-, and 6-month schedule and 3159 mIU/mL for children on the 0-, 12-, and 24-month schedule. Body mass index was correlated inversely with final antibody concentration, but age was not a fatter after adjustment for body mass index. Discussion. Engerix-B administered on a 0-, 12-, and 24-month schedule is highly immunogenic. Providers should consider this alternate immunization schedule for children who are at low risk of immediate exposure to hepatitis B infections.
引用
收藏
页码:1243 / 1247
页数:5
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