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Immunogenicity of hepatitis B vaccine in preterm infants
S C Kim1, E K Chung, R L Hodinka
1Children's Hospital of Philadelphia, Pennsylvania, USA.
Insights
Delayed hepatitis B vaccination at hospital discharge shows 90% immunogenicity in preterm infants. Higher birth weight and gestational age were associated with nonresponse to the hepatitis B vaccine.
Area of Science:
- Pediatrics
- Immunology
- Vaccinology
Background:
- Preterm infants are at increased risk for infectious diseases.
- Hepatitis B vaccination is crucial for preventing perinatal transmission and chronic infection.
- Optimal timing for initiating hepatitis B vaccine in preterm infants remains a key consideration.
Purpose of the Study:
- To evaluate the immunogenicity of a delayed hepatitis B vaccine schedule in preterm infants.
- To assess antibody response (antiHBs) when the first vaccine dose is administered at hospital discharge.
Main Methods:
- 102 preterm infants (23-36 weeks gestational age) received hepatitis B vaccine at discharge, with doses at 1 and 6 months.
- Serum samples were collected pre-vaccination and post-vaccination to measure antibody to hepatitis B surface antigen (antiHBs).
Main Results:
- 90% of infants achieved protective antiHBs levels (≥10 mIU/mL) after vaccination.
- The geometric mean antibody titer was 200 mIU/mL among responders.
- Infants with higher birth weight, gestational age, and less weight gain before vaccination were more likely to be nonresponders.
Conclusions:
- A delayed hepatitis B vaccination schedule initiated at hospital discharge is immunogenic in preterm infants.
- Factors such as higher birth weight and gestational age may predict nonresponse to hepatitis B vaccine in this population.
Objective:
To determine the immunogenicity of hepatitis B vaccine in preterm infants when the first dose of vaccine is delayed until hospital discharge.
Methods:
One hundred two preterm infants (23 to 36 weeks gestational age) born to hepatitis B surface antigen-negative mothers were enrolled. Immunization was initiated just before hospital discharge with subsequent doses 1 and 6 months later. Serum specimens were obtained before the administration of each vaccine dose and 3 months after the last dose and were tested for antibody to hepatitis B surface antigen (antiHBs).
Results:
Eighty-seven infants (85%) completed the study. Ninety percent (n = 78) of infants who completed the study seroconverted (antiHBs > or = 10 mIU/mL); 10% (n = 9) remained seronegative at study completion. The geometric mean antibody titer to hepatitis B surface antigen for infants who seroconverted was 200 mIU/mL. Nonresponders (NR) differed from responders (R) in birth weight (NR = 2090 g, R = 1560 g) gestational age (NR = 33 weeks, R = 31 weeks), and weight gain before vaccine initiation (NR = 244 g, R = 633 g). There were no differences in weight or age at vaccine initiation, Apgar scores, interval between vaccine doses, or bacterial infections, steroid use, or transfusions before vaccine initiation.
Conclusions:
Ninety percent of preterm infants responded to hepatitis B vaccine when the first dose of vaccine was delayed until hospital discharge. Nonresponders were more likely to be preterm infants of higher birth weight and higher gestational age, and to have gained less weight before vaccine initiation.