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March 16, 1994

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

Author Affiliations

From the Department of Neonatology, National University Hospital, Singapore (Dr Tan), the Quarantine and Epidemiology Department, Ministry of the Environment, Singapore (Dr Goh), the Department of Clinical Research, Singapore General Hospital (Dr Oon), and the Department of Microbiology, National University of Singapore (Dr Chan).

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

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)