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Immunogenicity of hepatitis B vaccine in preterm infants
O Blondheim1, D Bader, M Abend
1Department of Neonatology, Haemek Medical Center, Afula, Israel. blond@nltvision.net.il
Insights
Hepatitis B vaccination soon after birth is effective for most preterm infants. While protective antibody levels are similar, term infants show higher antibody titers after the third dose.
Area of Science:
- Pediatrics
- Immunology
- Vaccinology
Background:
- Hepatitis B infection poses a significant risk to newborns.
- Early vaccination is crucial for preventing vertical transmission and lifelong infection.
- Preterm infants may have different immune responses to vaccines compared to term infants.
Purpose of the Study:
- To evaluate the immunogenicity of a three-dose hepatitis B vaccine regimen in preterm infants.
- To compare the immune response in preterm infants with that of term infants when vaccinated shortly after birth.
Main Methods:
- A comparative study involving 176 preterm infants (< 35 weeks gestation) and 46 term infants.
- Hepatitis B vaccine administered in three doses starting soon after birth.
- Antibody titers measured 1-2 months post-third dose; Student's t-test used for statistical analysis.
Main Results:
- Similar proportions of preterm and term infants achieved protective hepatitis B antibody titers (88.7% vs 93.4%, p=NS).
- Term infants exhibited significantly higher geometric mean antibody titers post-vaccination compared to preterm infants (701.2 vs 469.1 mU/ml, p<0.03).
Conclusions:
- The hepatitis B vaccine demonstrates effectiveness in the majority of preterm infants when administered early.
- Consideration should be given to assessing immune response at 12-24 months for potential booster vaccination in non-responders.
Aim:
To assess the immunogenicity of hepatitis B vaccine in preterm and term infants, given in a sequence of three doses beginning soon after birth.
Method:
The immunogenicity of hepatitis B vaccine was assessed in 176 preterm infants (< 35 weeks of gestation), immunised soon after birth, and compared with that in 46 term infants. Titres of hepatitis B antibodies were determined one to two months after the third vaccine. The significance of the differences between the term and preterm groups was determined using Student's t test.
Results:
A similar proportion of infants in both preterm and term groups attained protective titres of hepatitis B antibodies (88.7% vs 93.4%, respectively; p = NS). However, the term infants had a higher geometric mean titre of antibodies after the third vaccine than did the preterm infants (701.2 (745.0) vs 469.1 (486.2) mU/ml, respectively; p < 0.03).
Conclusion:
Hepatitis B vaccine is effective in most preterm infants when given soon after birth. It may be advisable to determine the immune response at 12-24 months of age to booster the non-responders.
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