Assessment of a universal, school-based hepatitis B vaccination program.
OBJECTIVE
To assess a hepatitis B vaccination program offered to all grade 6 students in British Columbia in 1992.


METHODS
Cohort study.


METHODS
British Columbia, Canada.


METHODS
All grade 6 students were offered vaccine. Subsets of 454 and 259 students participated in studies of minor adverse events and seroresponse, respectively.


METHODS
The vaccine used was Engerix-B, 20 micrograms, given at intervals of 0, 1, and 6 months.


METHODS
Province-wide acceptance and series completion rates and reports of severe adverse events. Minor adverse events and immunogenicity in subsamples.


RESULTS
A total of 127,922 vaccine doses were administered. Initial enrollment totaled 43,358 students or 95.4% of those eligible. The series was completed by 41,594 students (95.6%). Minor adverse events were infrequent in the cohort assessed: no absenteeism or physician visits resulted from vaccination. Sixty-nine reported severe adverse events met surveillance definitions, the major categories being injection site reactions (23% of reports), fainting (20%), and rashes (17%). There was one instance of anaphylaxis. Only 13 of these events resulted in recommendations to discontinue the series. Of students tested following the series, 98% had levels of antibody to hepatitis B surface antigen considered to be protective (> or = 10 IU/L), the geometric mean titer being 690 IU/L (95% confidence interval, 498 to 957 IU/L).


CONCLUSIONS
Our experience indicates that school-based programs for universal vaccination of preadolescents can be highly acceptable and efficient.
Dobson
S
S
Vaccine Evaluation Center, British Columbia's Children's Hospital, Vancouver, Canada.
Scheifele
D
D
Bell
A
A
D000293:Adolescent; D001955:British Columbia; D002648:Child; D015331:Cohort Studies; D006509:Hepatitis B / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000096:biosynthesis; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D015397:Program Evaluation; D012572:School Health Services; D014611:Vaccination / Q000009:adverse effects; D014614:Vaccines, Synthetic / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology
C075654:Engerix-B; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic