Revaccination of non- and low- responders after a standard three dose hepatitis B vaccine schedule.
BACKGROUND
Guangdong province of China is HBV high endemicity and 1.6 million neonates are administrated 5 μg yeast recombinant anti-HBV vaccine each year. But few studies are performed to evaluate the immunogenicity and revaccination effect on non- and low- responders.


METHODS
2,199 children were administered intramuscularly with 5 μg vaccine at 0, 1 and 6 mo after birth. A 3 ml blood sample was drawn from each infant 1 mo after the third dose for determination of anti-HBs level. Three additional doses (10 μg each) were given to non- and low- responders.


RESULTS
Of 1,814 subjects, 3.1% were non-responders (anti-HBs titer < 10 mIUml (-1) ) and 28.9% were low-responders (anti-HBs ≥ 10 mIUml (-1) and < 100 mIUml (-1) ). Low birth weight (LBW) was a risk factor for non- and low- responders (RR = 1.6, 95%CI = 1.2-2.0). After revaccination, of the 34 non-responders, 14.7% became low-responders and 85.3% became responders. Of the 74 low-responders, 21.6% remained at the same level and 78.4% shifted into responder category.


CONCLUSIONS
Based on the lower responding rate after the primary immunization cycle and the higher responding rate after the additional cycle, measurement of anti-HBs level should be considered for people who had been immunized with three-dose 5 μg HB vaccine in Guangdong, especially for specific populations including LBW infants, healthcare workers, and patients with immunodeficiency disorders. An amount of 10 μg vaccine should be revaccinated to any non- and low- responders to provide adequate seroprotection.
Guangdong Center for Disease Control and Prevention, Guangzhou, Guangdong, P.R. China.
Ke
K
Han
Xiaoping
X
Shao
Huizhen
H
Zheng
Chenggang
C
Wu
Jianqiong
J
Zhu
Xiaoli
X
Zheng
Yonghui
Y
Zhang
D002681:China / Q000453:epidemiology; D019353:Endemic Diseases; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D007117:Immunization, Secondary / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D007273:Injections, Intramuscular; D008297:Male; D016896:Treatment Outcome; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000276:immunology
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic