title: Control of hepatitis B through routine immunization of infants: the need for flexible schedules and new combination vaccine formulations.
abstract: Universal immunization of infants is essential to the control of hepatitis B in areas of high endemicity where infection commonly occurs in infants and children. It is also an attractive strategy for ultimately reducing hepatitis-B-associated acute and chronic liver disease in areas of lower endemicity where infections occur primarily in adolescents and adults. Integration of hepatitis B vaccine with other routine paediatric immunizations, using flexible scheduling, will enhance compliance while minimizing the need for additional resources. Clinical studies demonstrate that a very high proportion of healthy infants and adults develop a protective level of antibody when given hepatitis B vaccine using a wide range of schedules. Compliance with universal vaccination of infants against hepatitis B may be enhanced by the development of new combination vaccines (e.g. diphtheria-tetanus-pertussis-Haemophilus influenzae b-hepatitis B) that allow complete immunization against several antigens with a minimal number of injections.
authors.affiliation: Merck Research Laboratories, Department of Infectious Diseases, West Point, PA 19486.
authors.forename: D J
authors.initials: DJ
authors.lastname: West
authors.forename: G B
authors.initials: GB
authors.lastname: Calandra
authors.forename: T M
authors.initials: TM
authors.lastname: Hesley
authors.forename: V
authors.initials: V
authors.lastname: Ioli
authors.forename: W J
authors.initials: WJ
authors.lastname: Miller
mesh_terms: D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000008:administration & dosage; D006514:Hepatitis B Surface Antigens / Q000008:administration & dosage / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000302:isolation & purification; D006801:Humans; D007115:Immunization Schedule; D007136:Immunoglobulins / Q000008:administration & dosage; D007223:Infant; D011247:Pregnancy
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D007136:Immunoglobulins