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[Premature infants and hepatitis B vaccination. Study Group Prevention Neonatal Hepatitis B]
R Del Canho1, P M Grosheide, L J Gerards
1Afd. Interne geneeskunde II, Academisch Ziekenhuis Rotterdam, Dijkzigt.
Insights
Preterm infants show adequate immune responses to hepatitis B vaccination, similar to term infants. This supports current vaccination schedules without age correction for preterm infants, ensuring comparable protection.
Area of Science:
- Pediatrics
- Immunology
- Vaccinology
Background:
- Dutch health authorities recommend vaccinating preterm infants at the same age as term infants since 1986.
- This recommendation is based on prior studies showing similar immune responses to DTP vaccination in both groups.
- Previous research indicated comparable immune responses to DTP vaccination in preterm and term infants.
Purpose of the Study:
- To evaluate the immunogenicity of hepatitis B vaccination in preterm infants when not corrected for gestational age.
- To compare antibody titers (anti-HBs) in preterm and term infants after hepatitis B vaccination.
Main Methods:
- A comparative study involving 44 preterm infants and 829 term infants.
- Measurement of anti-HBs titers post-hepatitis B vaccination.
- Analysis of immune response based on varying vaccination schedules (dose, number, timing).
Main Results:
- Over 95% of preterm infants achieved an adequate immune response (> 10 IU/l anti-HBs).
- The percentage of preterm infants with adequate anti-HBs titers (98%) was comparable to term infants (98%).
- No significant differences in immune response were observed across different vaccination schemes or timing.
Conclusions:
- Hepatitis B vaccination without gestational age correction is immunogenic in preterm infants.
- Preterm infants achieve comparable hepatitis B immunity to term infants, supporting current vaccination guidelines.
- The findings validate the existing Dutch vaccination policy for preterm infants regarding hepatitis B immunization.
Abstract:
Since 1986 health authorities in the Netherlands advise to vaccinate preterm infants at similar age as term infants, without correction for their shortened gestational age. This advice was based on a study, which showed comparable immune responses after DTP vaccination in preterm and term infants. To assess the immunogenicity of hepatitis B vaccination not corrected for gestational age in preterm infants, we compared the antiHBs titer after hepatitis B vaccination in 44 preterm infants with the antiHBs titer in 829 term infants. More than 95% of the preterm infants developed an adequate immune response (> 10 IU/l antiHBs), irrespective the vaccination scheme which varied in vaccine dose, the number of vaccinations and the onset of the first vaccination. The percentage preterm infants with an antiHBs titer > 10 IU/l (98%) was not different of the corresponding percentage of term infants (98%). Similarly, no difference between preterm and term infants was observed when an antiHBs value of 100 IU/l was considered a positive response, neither when active immunisation started at month 0 or month 3. The geometric mean titre at 12 months of age was considered.