title: Efficacy of an accelerated hepatitis B vaccination program during pregnancy.
abstract: OBJECTIVE
  To estimate the feasibility and immunogenicity of an accelerated hepatitis B vaccination schedule of 0, 1, and 4 months in high-risk pregnant women.
  
  
  METHODS
  We conducted a prospective clinical trial of high-risk pregnant women who were hepatitis B surface antigen-negative at presentation for prenatal care. A detailed questionnaire was administered and eligible women received a hepatitis B vaccine intramuscularly on a 0-, 1-, and 4-month schedule. Adverse reactions and hepatitis B surface antigen seroconversion rates were documented. Factors influencing seroconversion were determined.
  
  
  RESULTS
  Two hundred high-risk pregnant women were enrolled; 84% completed the three-dose vaccine series. Seroconversion (hepatitis B surface antigen 10 milli-international units/mL or greater) after one dose was 56% (95% confidence interval [CI], 49-63%), 77% (95% CI, 71-83%) after two doses, and 90% (95% CI, 85-94%) after completing three doses. Body mass index was inversely associated with seroconversion rates (P<.001). There was no single body mass index above which seroconversion did not occur. There were no serious adverse events; injection site discomfort was the most prevalent complaint (10.5%).
  
  
  CONCLUSIONS
  An accelerated hepatitis B vaccination schedule at 0, 1, and 4 months in high-risk pregnant women is effective, practical, and well tolerated. This accelerated vaccine strategy can be completed during the course of pregnancy and provides another means of decreasing hepatitis B virus disease and transmission.
authors.affiliation: From The University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, Texas.
authors.forename: Jeanne S
authors.initials: JS
authors.lastname: Sheffield
authors.forename: Ashley
authors.initials: A
authors.lastname: Hickman
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tang
authors.forename: Kristie
authors.initials: K
authors.lastname: Moss
authors.forename: Atoosa
authors.initials: A
authors.lastname: Kourosh
authors.forename: Natalie M
authors.initials: NM
authors.lastname: Crawford
authors.forename: George D
authors.initials: GD
authors.lastname: Wendel
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D007115:Immunization Schedule; D011247:Pregnancy; D011295:Prenatal Care; D011446:Prospective Studies; D014611:Vaccination / Q000379:methods*
chemical_list: D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines