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Published on: April 4, 2011
Immune response in infants after universal high-dose hepatitis B vaccination: A community-based study in Beijing,
Min Xiao1, Qian Qiu1, Xinghuo Pang2
1Dept of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
Insights
Timely post-vaccination serologic testing is crucial for infants receiving the Hepatitis B vaccine. Maternal folic acid supplementation positively impacts antibody titers, while delayed testing may reduce effectiveness.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Hepatitis B virus (HBV) infection prevention in infants via vaccination is a global health priority.
- China recommends infant vaccination starting at birth.
- Beijing utilizes a 10 μg/dose recombinant yeast vaccine for infants, administered at birth, 1 month, and 6 months.
Purpose of the Study:
- To evaluate factors influencing immunologic vaccine response in infants receiving a 10 μg/dose Hepatitis B vaccine.
- To assess the impact of maternal nutrition, infant factors, and vaccination schedule on anti-HBs titers.
Main Methods:
- A retrospective cohort study included 3670 infants who completed the 3-dose 10 μg recombinant HB vaccine regimen.
- Evaluated effects of maternal nutrient status, infant birth condition, growth, vaccination timeliness, dosing interval, and post-vaccination serologic testing (PVST) interval on anti-HBs titers.
Main Results:
- 3666 infants were analyzed; mean anti-HB titers were 1767.17 mIU/ml.
- Only 16.9% of infants completed PVST within 30-59 days post-vaccination.
- Delayed PVST and maternal folic acid supplementation were significantly associated with log-transformed anti-HB titers. Infant calcium supplementation showed a trend toward association.
Conclusions:
- The timing of PVST is critical to prevent unnecessary infant revaccination.
- Further multi-center studies are needed to confirm the influence of folate and calcium supplementation on Hepatitis B vaccine response.
Background:
Vaccination of infants beginning at birth is recommended to prevent Hepatitis B virus (HBV) infection in China. Compared to 5 μg/dose vaccine administered in other regions in China, a three-dose HB recombinant yeast vaccine at 10 μg/dose has been administered for infants within 24h after birth, 1 month and 6 months of age in Beijing since 2006. In a community-based retrospective cohort study, factors influencing immunologic vaccine response were evaluated.
Methods:
A total of 3670 infants who completed a 3-dose 10 μg recombinant HB vaccine regimen and born to hepatitis B antigen negative mothers were included. The effect on anti-HBs titers of maternal nutrient status, infants' birth condition, growth factors, timeliness of vaccination, dosing interval and the interval until post-vaccination serologic testing (PVST) were evaluated.
Results:
A total of 3666 infants with no markers of HBV infection were included in analysis. The mean anti-HB titers were 1767.17 mIU/ml. Only 16.9% of the infants completed their PVST within 30-59 days after the final dose of vaccination. Multivariate linear regression analysis showed that delay in PVST (β=-0.097, p<0.0001) and maternal folic acid supplementation (β=0.067, p=0.002) were associated with log-transformed anti-HB titers. Also a trend toward significant association was observed between the calcium supplementation of infants and log-transformed anti-HBs titers (β=0.062, p=0.057). Longer interval between dose 2 and dose 3 was not observed to increase the anti-HB titers after cofactors adjustment.
Conclusions:
Our findings illustrate the importance of timing of PVST to avoid unnecessary revaccination. Multi-center large cohort studies should verify the effect and magnitude of folate and calcium supplementation on HB vaccine response.
