Immunogenicity of Hepatitis B vaccine in preterm and full term infants vaccinated within the first week of life

• Published in: Vaccine Vol. 20; no. 11; pp. 1557 - 1562
• Main Authors: Freitas da Motta, Márcia Soares, Mussi-Pinhata, Marisa Márcia, Jorge, Salim Moysés, Tachibana Yoshida, Clara Fumiko, Sandoval de Souza, Cleonice Barbosa
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 22.02.2002; Elsevier
• Subjects: Biological and medical sciences; Epidemiology. Vaccinations; Female; Full term neonate; General aspects; Hepatitis B - immunology; Hepatitis B - prevention & control; Hepatitis B - transmission; Hepatitis B Antibodies - blood; Hepatitis B Surface Antigens - blood; Hepatitis B vaccine; Hepatitis B Vaccines - administration & dosage; Hepatitis B Vaccines - immunology; Hepatitis B virus; Human viral diseases; Humans; Immunization Schedule; Immunogenicity; Infant; Infant, Newborn - immunology; Infant, Premature - immunology; Infectious Disease Transmission, Vertical; Infectious diseases; Male; Medical sciences; Preterm neonate; Vaccines, Synthetic - administration & dosage; Vaccines, Synthetic - immunology; Viral diseases; Viral hepatitis; Preterm neonate; Hepatitis B vaccine; Immunogenicity; Full term neonate; Human; Infection; Viral hepatitis B; Viral disease; Vaccination; Digestive diseases; Hepatic disease; Infant; Vaccine
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/S0264-410X(01)00493-5

The immunogenicity of a Hepatitis B vaccine was evaluated in 110 neonates (57 full term and 53 preterm) born to Hepatitis B surface antigen (HBsAg) negative mothers. Three 10 μg doses of recombinant Hepatitis B vaccine were administered: the first dose within the first week of life; the second between 1 and 2 months; and the third at 5–7 months of age. Anti-HBs antibody titres were measured 3 months after the third dose. The seroconversion rate in preterm infants (77%; 95% CI=64.7–87.1) was significantly lower than in full term infants (98%; 95% CI=91.6–99.9) while the mean anti-HBs titres among those infants that did seroconvert was lower in preterm (186.6 mIU ml −1) than in full term infants (537.5 mIU ml −1). More full term than preterm infants showed titres greater than 100 mIU ml −1 (71.9 and 41.5%, respectively). We conclude that the administration of a recombinant Hepatitis B vaccine shortly after birth is less immunogenic in preterm infants weighing <1800 g at birth than in full term infants. Currently accepted recommendations for post exposure perinatal prophylaxis may be inadequate to protect preterm infants.