Comparative trial of low-dose, intradermal, recombinant- and plasma-derived hepatitis B vaccines

Article Abstract:

Hepatitis B virus causes approximately 25,000 cases of hepatitis B infection and 400 deaths annually. It is also one of the most significant causes of nosocomial (hospital-acquired) infection among health care workers. The first hepatitis B vaccine (HBV) was plasma-derived, and marketed in 1982. A second recombinant DNA-derived vaccine (RHBV) was introduced in 1987. Widespread use of vaccines for preventing hepatitis B has not been strongly encouraged because of the considerable expense of the required dose schedule. Studies with early vaccines and later with plasma-derived HBV vaccine showed that low-dose intradermal (injection into the skin) vaccination elicited satisfactory antibody responses. To evaluate the immunogenicity and reactogenicity of RHBV and HBV vaccines, 153 volunteers received either high-dose intramuscular (injection into the muscle) RHBV, low-dose intradermal RHBV, or low-dose intradermal HBV vaccine. The vaccines were administered in three doses, and all volunteers tested negative for hepatitis antigens prior to the study. The volunteers who were given low-dose intradermal HBV and high-dose RHBV vaccines had similar antibody responses; 90 percent and 94 percent, respectively, produced adequate antibody to hepatitis B. However, only 78 percent of those vaccinated with low-dose intradermal RHBV had satisfactory antibody; they were considered to be inadequately protected against hepatitis B. Although low-dose intradermal HBV vaccine provides cost-effective immunization against hepatitis B, high-dose intramuscular RHBV stimulates significantly greater antibody protection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Hepatitis B virus

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Simultaneous vaccination for hepatitis A and B

Article Abstract:

Hepatitis B has been the primary focus of immunization campaigns against hepatitis. Since hepatitis B can lead to chronic liver disease, cirrhosis, and liver cancer, it is a more serious threat to public health than is hepatitis A. However, since immunity to hepatitis A is falling in industrial countries, an increasingly large segment of the population is becoming susceptible to this disease. Therefore, there is some rationale for the use of a combined vaccine, so that patients may be immunized against hepatitis A and B at the same time. A combination vaccine was prepared by mixing killed hepatitis A virus with a commercially available vaccine consisting of hepatitis B surface antigen (HBsAg). Fifteen volunteers without hepatitis antibodies were inoculated three times, at one-month intervals. Measurement of the serum antibodies elicited by this vaccine revealed that the level of antibodies against hepatitis A was higher among subjects injected with the combination vaccine than among patients who were vaccinated against hepatitis A alone; this difference became less pronounced by 48 weeks after the first injection, however. Of the 15 subjects, 14 developed satisfactory levels of antibodies against hepatitis B after the series of injections. Eleven volunteers were tested after 48 weeks, and were found to still have high titers of antibodies against both hepatitis A and B at that time. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hepatitis, Viral, Viral hepatitis, Immunization, Hepatitis A

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Hepatitis B: recommendations for children/adolescents

Article Abstract:

Updates on guidelines for administering vaccinations against the hepatitis B (HepB) virus have been presented. It has been recommended that all children born to HepB-negative mothers begin a series of HepB vaccinations at two months of age. Vaccinations can also begin in adolescence for previously unvaccinated children. High-risk infants should receive vaccinations at birth. Reported side effects in children have been minimal. An immune protein treatment called HepB immune globulin may be advisable for unvaccinated exposed patients.

Standards, Children, Vaccination of children, Vaccination

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