UK vaccination schedule: persistence of immunity to hepatitis B in children vaccinated after perinatal exposure

Tom A Yates, Karthikeyan Paranthaman, Ly-Mee Yu, Elizabeth Davis, Sarah Lang, Scott J Hackett, Steven B Welch, Andrew J Pollard, Matthew D Snape, Tom A Yates, Karthikeyan Paranthaman, Ly-Mee Yu, Elizabeth Davis, Sarah Lang, Scott J Hackett, Steven B Welch, Andrew J Pollard, Matthew D Snape

Abstract

Objective: To assess persistence of immunity to hepatitis B (HBV) in primary school children vaccinated following perinatal exposure.

Design: Serological survey.

Setting: Five UK sites (Berkshire East, Birmingham, Buckinghamshire, Milton Keynes and Oxfordshire).

Participants: Children from 3 years 4 months to 10 years of age (mean age 6.2 years), vaccinated against HBV from birth following perinatal exposure.

Interventions: A single booster dose of the paediatric formulation of a recombinant HBV vaccine.

Main outcome measures: Titres of antibody against hepatitis B Surface Antigen (anti-HBs) measured immediately before and 21-35 days after the HBV vaccine booster.

Results: Prebooster anti-HBs titres were >10 mIU/ml in 84.6% of children (n=26; 95% CI 65.1 to 95.6%). All children (n=25, 95% CI 86.3 to 100%) had titres >100 mIU/ml after the booster.

Conclusions: This study of antibody persistence among UK children born to hepatitis B infected women, immunised with a 3-dose infant schedule with a toddler booster suggests sustained immunity through early childhood. These data should prompt further studies to address the need for a preschool booster.

Trial registration: Eudract Number 2008-004785-98.

Keywords: Immunisation; Immunology.

Figures

Figure 1
Figure 1
Summary of the recruitment process.
Figure 2
Figure 2
The data included in the intention-to-treat analysis, presented as a reverse cumulative distribution curve.

References

    1. World Health Organisation Hepatitis B vaccines. Wkly Epidemiol Rec 2009;84:405–19
    1. Lee C, Gong Y, Brok J, et al. Hepatitis B immunisation for newborn infants of hepatitis B surface antigen-positive mothers. Cochrane Database Syst Rev 2006;(2):CD004790.
    1. Department of Health Immunisation against infectious disease, 2006. (accessed 12 Jan 2012)
    1. European Consensus Group on Hepatitis B Immunity Are booster immunisations needed for lifelong hepatitis B immunity? Lancet 2000;355:561–5
    1. Butler J, Chambers SM. Immunoassay in clinical biochemistry. In: Burnett D, Crocker J, eds. The science of laboratory diagnosis. 2nd edn Chichester: John Wiley & Sons, 2005: 373–80
    1. Leuridan E, Van Damme P. Hepatitis B and the need for a booster dose. Clin Infect Dis 2011;53:68–75
    1. West DJ, Calandra GB. Vaccine induced immunologic memory for hepatitis B surface antigen: implications for policy on booster vaccination. Vaccine 1996;14:1019–27
    1. Boxall EH, A Sira J, El-Shuhkri N, et al. Long-term persistence of immunity to hepatitis B after vaccination during infancy in a country where endemicity is low. J Infect Dis 2004;190:1264–9
    1. Poorolajal J, Mahmoodi M, Haghdoost A, et al. Booster dose vaccination for preventing hepatitis B. Cochrane Database Syst Rev 2010;(11):CD008256.
    1. Coursaget P, Leboulleux D, Soumare M, et al. Twelve-year follow-up study of hepatitis B immunization of Senegalese infants. J Hepatol 1994;21:250–4
    1. Jack AD, Hall AJ, Maine N, et al. What level of Hepatitis B antibody is protective? J Infect Dis 1999;179:489–92
    1. Mele A, Tancredi F, Romanò L, et al. Effectiveness of hepatitis B vaccination in babies born to hepatitis B surface antigen-positive mothers in Italy. J Infect Dis 2001;184:905–8
    1. Bracciale L, Fabbiani M, Sansoni A, et al. Impact of hepatitis B vaccination in children born to HBsAg-positive mothers: a 20-year retrospective study. Infection 2009;37:340–3
    1. Roznovsky L, Orsagova I, Kloudova A, et al. Long-term protection against hepatitis B after newborn vaccination: 20-year follow-up. Infection 2010;38:395–400
    1. Health Protection Agency Quarterly vaccination coverage statistics for children aged up to five years in the UK (COVER programme): April to June 2012. Health Protection Report 2012;6:7–13
    1. Flood J, Amirthalingam G, Ramsay ME, et al. The diagnosis of chronic Hepatitis B infection among children born in England after introduction of universal antenatal HBV screening programme. Poster presented at the European Society of Paediatric Infectious Disease Meeting, The Hague, June 2011. (accessed 20 Jul 2012)
    1. Larcher VF, Bourne J, Aitken C, et al. Overcoming barriers to hepatitis B immunisation by a dedicated hepatitis B immunisation service. Arch Dis Child 2001;84:114–19
    1. Delamoth T. BMJ Group awards. Secondary care team of the year: the magic of teamwork. BMJ 2011;342:d2320

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する