Long-term follow-up of hepatitis B vaccine in infants of carrier mothers.
A program of immunization against hepatitis B, consisting of one dose of hepatitis B immune globulin within 12 hours of birth and three doses of hepatitis B vaccine at 0, 1, and 6 months of age for all infants of carrier mothers, has been operating in British Columbia, Canada, since 1984. The authors report on a survey conducted in 1992 of children immunized between 1984 and 1989. The survey included blood tests obtained from the children and interviews of the mothers. A total of 770 of 1,135 eligible children participated. Thirty-one percent of the mothers had been positive for hepatitis B e antigen prior to the birth of the child. At follow-up, the overall antibody against hepatitis B surface antigen seropositivity rate for children was 87.9 percent. A total of 5.1 percent of children had evidence of previous hepatitis B infection, and 2.3 percent were hepatitis B surface antigen positive. In multiple logistic regression analysis, a delay in the initial dose of vaccine was associated with increased risk of infection, but the age of the child was not, even though antibodies against hepatitis B surface antigen declined with age. The authors conclude that most infections occurred early and resulted from prenatal infection, initial nonresponse, or a delay in the initial dose of vaccine, not from waning immunity. A booster dose of vaccine, at least up to age 8 years, is not necessary.
Marion
S A
SA
Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Tomm Pastore
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M
Pi
D W
DW
Mathias
R G
RG
D000704:Analysis of Variance; D002353:Carrier State / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000517:prevention & control* / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D012044:Regression Analysis; D016036:Seroepidemiologic Studies
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines