Hepatitis B vaccine administered to children and adolescents at yearly intervals
Hepatitis B vaccine administered to children and adolescents at yearly intervals
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DOI：
10.1542/peds.103.6.1243
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发表时间：
1999-06-01
期刊：
影响因子：
8
通讯作者：
Krause, DS
中科院分区：
文献类型：
--
作者：
Halsey, NA;Moulton, LH;Krause, DS
目标。乙肝疫苗通常按0、1至2和6个月的时间表接种。已经研究了第二次和第三次接种之间更长的间隔，但第一次和第二次接种之间间隔2个月接种乙肝疫苗的有效性尚未被研究。我们的目标是比较间隔12个月接种Engerix-B乙肝疫苗的受者的抗体应答与间隔0、1和6个月接种疫苗的应答。总共有389名5到16岁的儿童被随机分成三组，分别接受Engerix-B(10毫克)的治疗，时间间隔为0、1和6个月，或0、12和24个月。于第三次服药前及服药后1个月抽血。在第三次接种前，92.3%的0、1和6个月计划接种的儿童和88.8%的0、12和24个月计划接种的儿童的乙肝表面抗体(抗-HBs)抗体浓度大于或等于10mIU/ml。在0个月、1个月和6个月计划中，95%的儿童按照方案接受了第三剂，而在0、12、24个月计划中的儿童中，90%的儿童接受了第三次剂量。0、II和6个月方案的受试者在第三次接种前的几何平均抗-HBs浓度(117.9 mIU/ml)略低于按0、12和24个月方案接种疫苗的儿童(162.1 mIU/m L)。第三次接种后1个月，98%的儿童抗-HBs浓度大于或等于10mIU/m L，两组均观察到较高的几何平均抗体浓度：0、1和6个月方案的儿童为5687m IU/m L，0、12和24个月方案的儿童为3159m IU/m L。体重指数与最终抗体浓度呈负相关，但调整体重指数后，年龄并未增加。按照0、12和24个月的时间表给予Engerix-B是高度免疫原性的。对于直接接触乙肝病毒感染风险较低的儿童，提供者应考虑采用这种替代免疫计划。
Objective. Hepatitis B vaccines are usually administered on a schedule of 0, 1 to 2, and 6 months. Longer intervals between the second and third doses have been studied, but the effectiveness of hepatitis B vaccine administered at intervals of >2 months between the first and second doses have not been studied. Our objective was to compare the antibody response in recipients of Engerix-B hepatitis B vaccine administered at 12-month intervals to the response to vaccine administered at 0, 1-, and 6-month intervals.Methods. A total of 389 children, 5 through 16 years of age, were randomized to receive Engerix-B (10 mg) at a schedule of either 0-, 1-, and 6-month intervals or 0-, 12-, and 24-month intervals. Blood was drawn before and 1 month after the third dose.Results. Immediately before the third dose of vaccine, 92.3% of children who received vaccine on the 0-, 1-, and 6-month schedule and 88.8% of children who received the 0-, 12-, and 24-month schedule had antibody to hepatitis B surface (anti-HBs) antigen concentrations greater than or equal to 10 mIU/mL. Of the children in the 0-, 1-, and 6-month schedule, 95% received the third dose according to protocol versus 90% of those in the 0-, 12-, 24-month schedule. The geometric mean anti-HBs concentration just before the third dose for recipients of the 0-, Ii and 6-month schedule (117.9 mIU/mL) was somewhat lower than that for the children who had received vaccine on the 0-, 12-, and 24-month schedule (162.1 mIU/mL). One month after the third dose, >98% of all children had anti-HBs concentrations greater than or equal to 10 mIU/mL and high geometric mean antibody concentrations were observed in both groups: 5687 mIU/mL for children on the 0-, 1-, and 6-month schedule and 3159 mIU/mL for children on the 0-, 12-, and 24-month schedule. Body mass index was correlated inversely with final antibody concentration, but age was not a fatter after adjustment for body mass index.Discussion. Engerix-B administered on a 0-, 12-, and 24-month schedule is highly immunogenic. Providers should consider this alternate immunization schedule for children who are at low risk of immediate exposure to hepatitis B infections.