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Immunogenicity of Two Versus Three Doses of Hepatitis B Vaccine When Administered to Children Aged 2-18 Months: A
Koffi Barnabé Kegbevi1,2, Yossi Febriani2, Chantal Sauvageau1,2,3
1Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, Québec, Canada.
Insights
A two-dose hepatitis B vaccine schedule in infants showed high protection and similar long-term immune response compared to a three-dose schedule. The heterologous two-dose schedule was more effective and safer for infants.
Area of Science:
- Pediatrics
- Immunology
- Vaccinology
Background:
- Hepatitis B vaccination schedules for infants are not well-established.
- Limited data exists on the immunogenicity of two-dose hepatitis B vaccine schedules in infants.
Purpose of the Study:
- To compare the immunogenicity and safety of two-dose versus three-dose hepatitis B vaccination schedules in infants.
- To evaluate the long-term immune response after different hepatitis B vaccination regimens.
Main Methods:
- Infants received either a two-dose homologous or heterologous schedule (at 2 and 12 months) or a three-dose homologous schedule (at 2, 4, and 18 months).
- All groups received a challenge dose three years later.
- Seroprotection rates, geometric mean titers (GMTs), and local reactions were assessed.
Main Results:
- High seroprotection rates (≥90%) were observed in all groups one month post-primary series.
- Two-dose schedules had lower initial GMTs than the three-dose schedule.
- Post-challenge, all groups showed similar anamnestic responses, with higher GMTs in the heterologous two-dose group.
- The heterologous two-dose schedule resulted in fewer local reactions compared to the homologous two-dose schedule.
Conclusions:
- Two-dose hepatitis B vaccination schedules in infants elicit comparable long-term immune responses to three-dose schedules.
- A heterologous two-dose schedule demonstrates superior immunogenicity and safety over a homologous two-dose schedule in infants.
Background:
A 2-dose hepatitis B vaccination schedule is highly immunogenic in children aged ≥1 year, but data for infants are scarce. Our goal was to compare the immunogenicity of 2- and 3-dose hepatitis B vaccination schedules in this population.
Methods:
Children in the experimental group were recruited at 2 months of age and randomized to receive a homologous (Infanrix-hexa/Infanrix-hexa) or heterologous (Infanrix-hexa/Twinrix) 2-dose schedule at 2 and 12 months. Children in the control group were recruited at 18 months and had received a homologous 3-dose schedule (Infanrix-hexa/Infanrix-hexa/Infanrix-hexa) at 2, 4, and 18 months. All groups received a challenge dose (Twinrix) 3 years later.
Results:
One month after the primary series, seroprotection rates (anti-HBs ≥10 mIU/mL) were high and similar among the 3 groups (heterologous 2-dose, 91.7%; homologous 2-dose, 90.9%; 3-dose, 94.2%). Geometric mean titers (GMTs) were lower in the 2-dose groups than in the 3-dose group. Post-challenge dose, the majority exhibited an anamnestic response, similar across all 3 groups (heterologous 2-dose, 97.2%; homologous 2-dose, 95.5%; 3-dose, 92.7%). GMTs were numerically higher in the heterologous 2-dose group (9380.5 mIU/mL) than in the 3-dose group (6900.6 mIU/mL) (P = .4). The proportion exhibiting local reactions was significantly lower after the heterologous 2-dose schedule than after the homologous 2-dose schedule.
Conclusions:
The anamnestic response 3 years after 2-dose (2 and 12 months) and 3-dose (2, 4, and 18 months) hepatitis B vaccination schedules was similar. The heterologous 2-dose schedule was more immunogenic and less reactogenic than the homologous 2-dose schedule.
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