Low Vaccine Immunoprophylaxis Failure Rates in Term Infants of Anti-HBs Carrier Mothers

Infant being vaccinated
Infant being vaccinated
Infants born to anti-HBs carrier mothers who are given either monovalent or combination hepatitis B vaccines have low rates of immunoprophylaxis failure.

Infants born to mothers with chronic hepatitis B who are given either monovalent or combination hepatitis B vaccines have shown low rates of immunoprophylaxis failure, according to a study recently published in the Journal of Paediatrics and Child Health.

This study included 330 newborn children, 177 of whom received monovalent hepatitis vaccine in 3 doses at age 0, 1, and 6 months (regimen A) and 115 of whom received 2 doses of monovalent vaccine at 0 and 1 months and 1 combination vaccine DTaP-IPV-Hib-Hepatitis B virus at 6 months (regimen B).

The vast majority of both regimens achieved full immunity. Regimen A experienced an immunoprophylaxis failure rate of 2.3%, while regimen B’s failure rate was 2.6% (P =1.00). The mean amount of hepatitis B surface antibodies in titration were similar between regimens, with regimen A at 643±374 and regimen B at 561±396 (P =.08). Gender, birth weight, delivery type, and gestational age were similar between the two treatment arms.

This study took place over 78 months and was conducted at 2 maternity units located in Singapore. Infants were born to mothers who were surface antigen-positive with chronic hepatitis B and who had completed the vaccination program. Infants whose mothers were taking antiviral therapy or who had concurrent HIV or hepatitis C were not included.

Immunoprophylaxis failure resulting in transmission of hepatitis B from mother to child was the primary measure of vaccine efficacy. Hepatitis B surface antibody levels were collected at 9 months of age to determine immunogenicity.

The study researchers conclude that “hepatitis B vaccine regimens using monovalent or combination vaccine for the third dose showed similarly high vaccine effectiveness and low immunoprophylaxis failure rate in term infants born to chronic hepatitis B carrier mothers.”

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Lee LY, Chan SM, Ong C, et al. Comparing monovalent and combination hepatitis B vaccine outcomes in children delivered by mothers with chronic hepatitis B [published online August 30, 2018]. J Paediatri Child Health. doi: 10.1111/jpc.14194