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Efficacy of a Mass Hepatitis B Vaccination Program in Taiwan Studies on 3464 Infants of Hepatitis B Surface Antigen—Carrier Mothers

Hsu-Mei Hsu, MS, MPH; Ding-Shinn Chen, MD; Cheng-Hua Chuang, MD; Joseph Chih-Feng Lu; De-Min Jwo, RN; Chin-Chang Lee, MS; Hsing-Chi Lu; Shih-Hsiung Cheng; Yue-Fen Wang, MPH; Chinying Chen Wang, PhD; Kwang-Juei Lo, MD; Chun-Jen Shih, MD; Juei-Low Sung, MD
JAMA. 1988;260(15):2231-2235. doi:10.1001/jama.1988.03410150079034.
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To evaluate the efficacy of the mass hepatitis B vaccination program in Taiwan in interrupting perinatal hepatitis B virus transmission, 3464 randomly selected 18-month-old infant vaccinees born to hepatitis B surface antigen—carrier mothers were recruited from 9697 eligible infants during a six-month period of the program. They were divided into ten groups according to maternal infectivity and compliance with the vaccination schedule. Serum samples were tested for hepatitis B surface antigen, antibody to hepatitis B surface antigen, and antibody to hepatitis B core antigen. In 786 infants who had highly infectious mothers and who received hepatitis B immune globulin and vaccine on schedule, the protective efficacy was about 85%. The efficacy seemed to be slightly lower in those immunized off schedule. Overall, 11% of infants still carried hepatitis B surface antigen, and 81% of the infants had antibody to hepatitis B surface antigen that exceeded 10 mlU/mL in more than 90% of them. The geometric mean titers of antibody to hepatitis B surface antigen were more than 200 mlU/mL in every group of infants. We conclude that the mass vaccination program is efficacious in preventing perinatal hepatitis B virus transmission and the chronic carrier state; most infant vaccinees have adequate levels of protective antibody at 18 months of age. This program is extremely significant in the control of hepatitis B virus infection in Taiwan.

(JAMA 1988;260:2231-2235)


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