Hepatitis B vaccination is effective for babies weighing less than 1800 g.
OBJECTIVE
This trial studied the effectiveness of early hepatitis B (HepB) immunisation in babies weighing less than 1800 grams, born of HepB surface-antigen-negative mothers.


METHODS
The first vaccine dose was given once clinical stability was achieved, with second and third doses given 1 and 6 months later, respectively. HepB serology, done using Abbott ElA (phase 1) and Abbott Axsym (phase 2) before and after June 2001, respectively, was checked at birth (Sero1), prior to (Sero2) and 6 months after (Sero3) the third dose. A booster dose was recommended when Sero3 showed a non-immune status (< 10 mIU/mL).


RESULTS
Median birth weight and gestational age (n = 118) were 1295 [range 475, 1780] g and 31 [range 24, 37] completed weeks, respectively. Sero1 (median age of 4 [range 1, 34] days) showed 64% (n = 113) to be non-immune. The first dose of vaccine was administered at a median weight of 1268 [range 530, 1790] g, median age of 6 [range 1-63] days and median post-menstrual age of 32 [range 24-37] completed weeks. Sero2 (median age of 179 [range 112-260] days), for 110 babies (93.2%) showed immunity in 48.2% (median titres--Phase 1: 26 [range 10, 150] mIU/mL; Phase 2: 34 [range 10, 1000] mIU/mL). Sero3 revealed seroprotection in 77.8% (median titres--Phase 1: 102 [range 12, 150] mIU/mL; Phase 2: 162 [range 16, 1000] mIU/mL). The more mature the bady at time of first dose, the more likely he is to achieve seroprotection (85% amongst those administered at and beyond 33 weeks; 91% among those administered at and beyond Day 10 at Sero3).


CONCLUSIONS
Early HepB immunisation in infants < 1800 g can be safely recommended, with booster doses necessary at 1 year for some infants.
Lian
Wee-Bin
WB
Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore. gnelwb@sgh.com.sg
Ho
Selina K-Y
SK
Yeo
Cheo-Lian
CL
D005260:Female; D005865:Gestational Age; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology* / Q000627:therapeutic use*; D006801:Humans; D007106:Immune Sera; D007223:Infant; D007230:Infant, Low Birth Weight / Q000276:immunology; D007231:Infant, Newborn; D007234:Infant, Premature; D011446:Prospective Studies; D012044:Regression Analysis; D014611:Vaccination / Q000009:adverse effects / Q000379:methods*
D017325:Hepatitis B Vaccines; D007106:Immune Sera