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Immunity to hepatitis B in two birth cohorts given plasma-derived or yeast-derived vaccine
C E Salmond1, D R Bandaranayake, M Tobias
1Department of Public Health, Wellington School of Medicine. salmond@wnmeds.ac.nz
Insights
Infants receiving the yeast-derived hepatitis B vaccine maintained protective antibody levels longer than those receiving the plasma-derived vaccine. This suggests yeast-derived vaccine recipients may not need a booster dose before age 11.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Hepatitis B vaccination is crucial for preventing infection.
- Different vaccine formulations, such as yeast-derived and plasma-derived, exist.
- Understanding long-term antibody response is essential for effective immunization schedules.
Purpose of the Study:
- To compare the antibody response to yeast-derived versus low-dose, plasma-derived hepatitis B vaccines in infants.
- To assess the durability of immune protection over time.
Main Methods:
- Two cohorts of infants received either yeast-derived or plasma-derived hepatitis B vaccine.
- Immunisation coordinators and general practitioners managed the vaccination process.
- Blood samples were collected at multiple time points (18 to 54 months) to measure antibody levels.
Main Results:
- Antibody levels declined significantly with age in both vaccine groups.
- At 4.5 years, 5.1% of children vaccinated with yeast-derived vaccine had sub-protective antibody levels.
- In contrast, 14.3% of children vaccinated with plasma-derived vaccine had sub-protective antibody levels.
Conclusions:
- Yeast-derived hepatitis B vaccine provides more durable antibody levels compared to low-dose, plasma-derived vaccine.
- Children vaccinated with yeast-derived vaccine may not require a booster dose at school entry.
- Consideration should be given to offering a booster dose to recipients of plasma-derived vaccine before age 11.
Aim:
To determine the antibody response to either yeast-derived or low-dose, plasma-derived hepatitis B vaccine, in two cohorts of infants monitored by an immunisation coordinator and immunised by general practitioners.
Methods:
Infants born to two cohorts of non-carrier mothers in Northland were followed up, the first receiving a low-dose, plasma-derived vaccine, the second a yeast-derived vaccine. An immunisation coordinator enrolled the mothers into the programme during pregnancy, promoted full immunisation against hepatitis B and later obtained blood samples from their babies. In each cohort, four subsamples of babies, randomly assigned, were bled for estimation of antibody levels to hepatitis B at ages 18, 30, 42 and 54 months (1 1/2, 2 1/2, 3 1/2, 4 1/2 years). No infant was bled more than once.
Results:
In both cohorts, antibody levels declined significantly with age. By age 4 1/2 years, 5.1% of children (95% confidence interval (CI): 3.5-7.1) immunised with yeast-derived vaccine were estimated to have antibody levels to hepatitis B below the acceptable level for protection of 10 IU/L. The proportion for those immunised with plasma-derived vaccine was 14.3% (95% CI: 7.4-24.1).
Conclusions:
Children receiving yeast-derived vaccine do not require a second booster dose at school entry, although this might be considered at age 11. There are grounds to suggest that those who received low-dose, plasma-derived vaccine (prior to 1990) should be offered a booster before age 11.