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Immune Response And Anamnestic Immune Response In Children After A 3-Dose Primary Hepatitis B Vaccination
Muhammad Faheem Afzal1, Muhammad Ashraf Sultan1, Ahmad Imran Saleemi1
1Department of Paediatrics, King Edward Medical University, Lahore, Pakistan.
Insights
Hepatitis B vaccination in Pakistani children showed only 58% protective antibody response. A booster dose improved immunity, but a birth dose is recommended to enhance Hepatitis B virus protection.
Area of Science:
- Immunology
- Public Health
- Pediatrics
Background:
- Hepatitis B virus (HBV) infections are a global health concern.
- Pakistan implemented universal infant vaccination against Hepatitis B in 2002 using a 3-dose schedule at 6, 10, and 14 weeks.
- This study evaluated the immune response in children following primary Hepatitis B vaccination.
Purpose of the Study:
- To determine the immune response in children aged 9 months to 10 years after a 3-dose primary Hepatitis B vaccination.
- To assess the anamnestic immune response after a booster dose in non-responsive children.
- To identify factors influencing antibody titers, such as time since last vaccination.
Main Methods:
- A cross-sectional study involving 200 children (9 months-10 years) in Lahore, Pakistan.
- Serum anti-HBsAb levels were measured using ELISA to assess protective immunity (≥10 mIU/mL).
- Non-responders received a booster dose, and the anamnestic response was measured 21-28 days later.
Main Results:
- Only 58% of children achieved protective antibody levels (anti-HBsAb ≥10 mIU/mL).
- Antibody levels showed a significant negative correlation with the time elapsed since the last vaccine dose (p=0.019).
- All children receiving a booster dose demonstrated a significant anamnestic response (p=0.00).
Conclusions:
- The current 3-dose Hepatitis B vaccination schedule with short intervals is insufficient for protecting 42% of the pediatric population.
- Introducing a birth dose of the Hepatitis B vaccine is recommended to improve long-term protection.
- Further research may be needed to optimize vaccination strategies in Pakistan.
Background:
Diseases caused by Hepatitis B virus (HBV) have a worldwide distribution. Pakistan adopted the recommendations of World Health Organization (WHO) for routine universal infant vaccination against hepatitis B in 2002, currently being administered at 6, 10, and 14 weeks of age in a combination vaccine. This study was conducted to determine the immune response & anamnestic immune response in children, 9 months-10 years of age, after a 3dose primary Hepatitis B vaccination.
Methods:
This cross sectional study was conducted in the Department of Paediatrics, King Edward Medical University/Mayo Hospital, Lahore, Pakistan, from January to June, 2014. A total of 200 children of either sex between the ages of 9 months to 10 years, documented to have received 3 doses of hepatitis B vaccines according to Expanded Program of Immunization (6,10,14 weeks) schedule in infancy, were recruited by consecutive sampling. The level of serum antiHBsAb by ELIZA was measured. Children with antiHBs titers ≥10 mIU/mL were considered to be immune. Those with anti HBsAb levels <10 mIU/mL were offered a booster dose of infant recombinant hepatitis B vaccine. The second serum sample was obtained 21-28 days following the administration of the booster dose and the anamnestic immune response was measured. Data was analysed using SPSS 17 to determine the relation between time interval since last vaccination and antibody titer. Chi square test was applied.
Results:
Of the 200 children, protective antibody response was found in 58%. Median serological response was 18.60 (range 2.82 - 65.15). Antibody levels were found to have a statistically significant ( pvalue 0.019) negative correlation with the time since last administration of vaccine. A booster dose of Hepatitis B vacci ne was administered to all nonresponders, with each registering a statistically significant (pvalue 0.00) anamnestic response.
Conclusions:
The vaccination schedule with short dosage interval was unable to provide protection to 42% of the study population. Introduction of birth dose of Hepatitis B vaccine to the existing schedule is recommended.
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