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Immunogenicity of hepatitis B vaccine in term and preterm infants
C Belloni1, G Chirico, A Pistorio
1Division of Neonatal Intensive Care, IRCCS Policlinico San Matteo, Pavia, Italy.
Insights
Preterm and low birthweight infants show similar hepatitis B vaccine response rates compared to full-term infants. This study found no significant differences in anti-HBs antibody levels after primary vaccination.
Area of Science:
- Immunology
- Neonatal Medicine
- Vaccinology
Background:
- Previous studies suggested lower hepatitis B vaccine seroconversion in premature, low birthweight infants.
- Concerns exist regarding vaccine efficacy in vulnerable neonatal populations.
Purpose of the Study:
- To compare hepatitis B vaccine seropositive rates in preterm versus full-term infants.
- To investigate vaccine response based on gestational age and birthweight.
- To assess antibody levels after primary hepatitis B vaccination.
Main Methods:
- A cohort of 2009 neonates received recombinant hepatitis B vaccine at birth, 1 month, and 6 months.
- Infants with severe illnesses or malformations were excluded.
- Anti-HBs antibody levels were measured 1 month after the third dose in 241 preterm and 1727 term infants.
Main Results:
- No statistically significant difference in anti-HBs antibody levels was found between preterm (<38 weeks) and term infants.
- Low birthweight (<2500g) infants demonstrated comparable antibody levels to normal weight infants.
- The hepatitis B vaccine response was consistent across different gestational ages and birthweights.
Conclusions:
- Preterm and low birthweight infants achieve similar hepatitis B vaccine immunogenicity as term infants.
- Current vaccination schedules appear effective for these neonatal subgroups.
- The study supports the use of hepatitis B vaccination in preterm and low birthweight neonates.
Abstract:
Some studies have suggested that decreased seroconversion rates might be found in premature infants with low birthweight (< 2000g) following administration of hepatitis B vaccine at birth. The aim of the present investigation was to evaluate possible differences in seropositive rates between full-term and preterm infants after primary vaccination, in particular when gestational age or birthweight is very low. Two-thousand and nine neonates born to HBsAg-negative mothers were vaccinated with 10 microg of recombinant hepatitis B virus (HBV) vaccine, from May 1991 to October 1994. Children with infections, congenital malformations or serious illnesses were excluded. HBV vaccine was administered intramuscularly, on the fourth day of life and again at 1 and 6 months of age. A 1-ml blood sample was drawn from each infant 1 month after the third vaccine dose for determination of the level of anti-HBs antibody. The response to HBV vaccination was evaluated in 241 preterm (gestational age <38 weeks) infants and 1727 term neonates. No statistical difference was observed in the distribution of anti-HBs antibody level, either between preterm infants (<38 weeks) and newborns of normal gestational age, or between low birthweight (<2500 g) and normal weight infants. The results suggest that preterm and low birthweight infants (<2500g) respond to HBV vaccine in the same measure as normal-term infants.