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Published on: February 1, 2017

Low dose hepatitis B vaccination in children

A Milne, G K Allwood, N E Pearce

    The New Zealand Medical Journal
    |February 12, 1986
    PubMed

    Insights

    This study evaluated hepatitis B vaccine efficacy in children. A two-microgram dose given intradermally proved effective, achieving over 90% seroconversion with minimal side effects for mass vaccination.

    Area of Science:

    • Pediatrics
    • Immunology
    • Vaccinology

    Background:

    • Hepatitis B virus (HBV) infection poses a significant global health risk, particularly in children.
    • Effective vaccination strategies are crucial for preventing HBV transmission and long-term sequelae.
    • Assessing vaccine efficacy across different age groups and administration routes is essential for public health initiatives.

    Purpose of the Study:

    • To evaluate the immunogenicity and efficacy of a two-microgram hepatitis B vaccine dose administered intradermally (ID) or intramuscularly (IM) in children.
    • To determine the optimal vaccination schedule and dosage for mass immunization programs in a high-risk mobile community.
    • To assess the impact of prior hepatitis B virus (HBV) exposure on vaccine response.

    Main Methods:

    • 169 HBsAg-negative children received three doses of hepatitis B vaccine (2 or 4 micrograms) at monthly intervals via ID or IM routes.
    • Children were tested for HBsAg, anti-HBs, and anti-HBc after the second and third vaccine doses.
    • Serological markers were analyzed to determine seroconversion rates, geometric mean titres (GMT), and evidence of prior infection.

    Main Results:

    • Overall, 74% and 71% seroconversion rates for anti-HBs were observed after two doses with 2 mcg and 4 mcg, respectively.
    • Prior HBV infection (anti-HBc positive) was identified in 4% of 3-5 year olds and 26% of 9-12 year olds.
    • After three doses, 91% of previously susceptible older children achieved acceptable anti-HBs GMTs, and all anti-HBc positive children sero-converted.

    Conclusions:

    • A 2 mcg dose of hepatitis B vaccine administered intradermally at monthly intervals is effective for mass vaccination.
    • This regimen provides over 90% seroconversion in susceptible children with low cost and minimal side effects.
    • The findings support the use of this vaccination strategy in high-risk pediatric populations to control hepatitis B transmission.

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