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March 16, 1994, Vol 271, No. 11 >
ARTICLE | March 16, 1994

Immunogenicity of Recombinant Yeast-Derived Hepatitis B Vaccine in Nonresponders to Perinatal Immunization FREE

K. L. Tan, FRCPE; K. T. Goh, MD; C. J. Oon, FRCP; S. H. Chan, FRCPA
[+] Author Affiliations

Reprint requests to Department of Neonatology, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 0511, Republic of Singapore (Dr Tan).


JAMA. 1994;271(11):859-861. doi:10.1001/jama.1994.03510350069039
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Article
References

Objective.  —Nonresponse to hepatitis B vaccine in the perinatal period occasionally occurs. This report documents the results of reimmunization of nonresponders to perinatal immunization.

Design.  —From a cohort of 1154 infants immunized with plasma-based vaccine in the perinatal period and followed up for more than 8 years, 45 nonresponders were identified. These children were reimmunized at 4 years of age. Each child received a yeast-derived recombinant hepatitis B vaccine on a 0-, 1-, and 5-month schedule, 33 children with 10-μg and 12 with 5-μg doses. Blood was sampled 1 month after the third vaccination and thereafter at 1, 2, and 4 years.

Setting.  —The follow-up clinic where the cohort of children was regularly seen.

Patients.  —Forty-five 4-year-old children who had no antibody to hepatitis B despite perinatal immunization.

Main Outcome Measure.  —Antibody levels to hepatitis B surface antigen.

Results.  —Seroconversion with titers higher than 10 mlU/mL occurred in all children. More than 70% still had titers higher than 10 mlU/mL 4 years after vaccination.

Conclusion.  —Nonresponders to perinatal hepatitis B vaccination respond well to subsequent vaccination.(JAMA. 1994;271:859-861)

REFERENCES

1 +
Committee on Epidemic Diseases.  Acute viral hepatitis surveillance, 1990. Epidemiol News Bull Singapore . (July) 1991;;17:37-39.
2 +
Yap EH, Ong YW, Simons MJ, Okochi Y, Mayumi M, Nishioka K.  Australia antigen in Singapore, II: differential frequency in Chinese, Malays and Indians. Vox Sang . 1972;;22:371-375.
3 +
Committee on Infectious Diseases, American Academy of Pediatrics.  Universal hepatitis B immunization. Pediatrics . 1992;;89:795-800.
4 +
Chan SH, Tan HL, Goh HT, et al.  Maternal-child hepatitis B virus transmission in Singapore. Int J Epidemiol . 1985;;14:173-177.
5 +
Stevens CE, Beasley RP, Tsui J, Lee WC.  Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med . 1975;;292:771-774.
6 +
Shiraki K, Yoshihara N, Kawana T, Yasui H, Sakurai M.  Hepatitis B surface antigen and chronic hepatitis in infants born to asymptomatic carrier mothers. AJDC . 1977;;131:644-647.
7 +
Oon CJ, Tan HL, Goh KT, et al.  Evaluation of low dose hepatitis B vaccine given within a childhood immunization programme in Singapore. J Infect . 1986;;13:155-167.
8 +
Flewett TH.  Can we eradicate hepatitis B? BMJ . 1986;;293:404-405.
9 +
Committee on Epidemic Diseases.  Prevalence of hepatitis B infection in children and adults, 1990-1991. Epidemiol News Bull Singapore . (July) 1992;; 18:39-40.
10 +
Immunization Practices Advisory Committee.  Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination. MMWR Morb Mortal Wkly Rep . 1991;;40( (RR-13) ):1-25.
11 +
Prozesky OW, Stevens CE, Szmuness W, et al.  Immune response of hepatitis B vaccine in newborns. J Infect . 1983;;7( (suppl 1) ):53-55.
12 +
Stevens CE, Taylor PE, Tong MJ, et al.  Prevention of perinatal hepatitis B virus infection with hepatitis B immune globulin and hepatitis B vaccine.  In: Zuckerman AJ, ed. Viral Hepatitis and Liver Disease . New York, NY: Alan R Liss Inc; 1988;:982-988.
13 +
Coursaget P, Yvonnet B, Chotard J, et al.  Seven-year study of hepatitis B vaccine efficacy in infancy from an endemic area (Senegal). Lancet . 1986;;2: 1143-1144.
14 +
Szmuness W, Stevens CE, Harley EJ, et al.  Hepatitis B vaccine: demonstration of efficacy in a controlled trial in a high risk population in the United States. N Engl J Med . 1980;;303:833-841.
15 +
Inskip HM, Hall AJ, Chotard J, Loik F, Whittle H.  Hepatitis B vaccine in the Gambian Expanded Programme on Immunization: factors influencing antibody response. Int J Epidemiol . 1991;;20:764-769.
16 +
Tan KL, Oon CJ, Goh KT, Wong LYM, Chan SH.  Immunogenicity and safety of low doses of recombinant yeast-derived hepatitis B vaccine. Acta Paediatr Scand . 1990;;79:593-598.
17 +
Maupas P, Chiron JP, Barin F, et al.  Efficacy of hepatitis B vaccine in prevention of early HBsAg carrier state in children: controlled trial in an endemic area (Senegal). Lancet . 1981;;1:289-292.
18 +
Egea E, Iglesias A, Salazar M, et al.  The cellular basis for lack of antibody response to hepatitis B vaccine in humans. J Exp Med . 1991;;173:531-538.
19 +
Alper CA, Kruskall MS, Marcus-Bagley D, et al.  Genetic prediction of nonresponse to hepatitis B vaccine. N Engl J Med . 1989;;321:708-712.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Committee on Epidemic Diseases.  Acute viral hepatitis surveillance, 1990. Epidemiol News Bull Singapore . (July) 1991;;17:37-39.
2 +
Yap EH, Ong YW, Simons MJ, Okochi Y, Mayumi M, Nishioka K.  Australia antigen in Singapore, II: differential frequency in Chinese, Malays and Indians. Vox Sang . 1972;;22:371-375.
3 +
Committee on Infectious Diseases, American Academy of Pediatrics.  Universal hepatitis B immunization. Pediatrics . 1992;;89:795-800.
4 +
Chan SH, Tan HL, Goh HT, et al.  Maternal-child hepatitis B virus transmission in Singapore. Int J Epidemiol . 1985;;14:173-177.
5 +
Stevens CE, Beasley RP, Tsui J, Lee WC.  Vertical transmission of hepatitis B antigen in Taiwan. N Engl J Med . 1975;;292:771-774.
6 +
Shiraki K, Yoshihara N, Kawana T, Yasui H, Sakurai M.  Hepatitis B surface antigen and chronic hepatitis in infants born to asymptomatic carrier mothers. AJDC . 1977;;131:644-647.
7 +
Oon CJ, Tan HL, Goh KT, et al.  Evaluation of low dose hepatitis B vaccine given within a childhood immunization programme in Singapore. J Infect . 1986;;13:155-167.
8 +
Flewett TH.  Can we eradicate hepatitis B? BMJ . 1986;;293:404-405.
9 +
Committee on Epidemic Diseases.  Prevalence of hepatitis B infection in children and adults, 1990-1991. Epidemiol News Bull Singapore . (July) 1992;; 18:39-40.
10 +
Immunization Practices Advisory Committee.  Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination. MMWR Morb Mortal Wkly Rep . 1991;;40( (RR-13) ):1-25.
11 +
Prozesky OW, Stevens CE, Szmuness W, et al.  Immune response of hepatitis B vaccine in newborns. J Infect . 1983;;7( (suppl 1) ):53-55.
12 +
Stevens CE, Taylor PE, Tong MJ, et al.  Prevention of perinatal hepatitis B virus infection with hepatitis B immune globulin and hepatitis B vaccine.  In: Zuckerman AJ, ed. Viral Hepatitis and Liver Disease . New York, NY: Alan R Liss Inc; 1988;:982-988.
13 +
Coursaget P, Yvonnet B, Chotard J, et al.  Seven-year study of hepatitis B vaccine efficacy in infancy from an endemic area (Senegal). Lancet . 1986;;2: 1143-1144.
14 +
Szmuness W, Stevens CE, Harley EJ, et al.  Hepatitis B vaccine: demonstration of efficacy in a controlled trial in a high risk population in the United States. N Engl J Med . 1980;;303:833-841.
15 +
Inskip HM, Hall AJ, Chotard J, Loik F, Whittle H.  Hepatitis B vaccine in the Gambian Expanded Programme on Immunization: factors influencing antibody response. Int J Epidemiol . 1991;;20:764-769.
16 +
Tan KL, Oon CJ, Goh KT, Wong LYM, Chan SH.  Immunogenicity and safety of low doses of recombinant yeast-derived hepatitis B vaccine. Acta Paediatr Scand . 1990;;79:593-598.
17 +
Maupas P, Chiron JP, Barin F, et al.  Efficacy of hepatitis B vaccine in prevention of early HBsAg carrier state in children: controlled trial in an endemic area (Senegal). Lancet . 1981;;1:289-292.
18 +
Egea E, Iglesias A, Salazar M, et al.  The cellular basis for lack of antibody response to hepatitis B vaccine in humans. J Exp Med . 1991;;173:531-538.
19 +
Alper CA, Kruskall MS, Marcus-Bagley D, et al.  Genetic prediction of nonresponse to hepatitis B vaccine. N Engl J Med . 1989;;321:708-712.

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