Delayed third hepatitis B vaccine dose and immune response

Prevention of mother to child transmission of hepatitis B infection

The likelihood of developing chronic hepatitis B infection and its complications is most when infection is transmitted vertically. Awareness of the current recommendations for managing babies of mothers who are hepatitis B carriers is not universal, resulting in failure of follow up, despite the serious long term implications, including development of hepatic carcinoma. We review the current guidelines of managing babies born to mothers who are hepatitis B carriers.

Epidemiology and prevention of hepatitis B virus infection

Hepatitis B virus (HBV) infection has been a major global cause of morbidity and mortality. The recognition of the problem led to a worldwide effort to reduce transmission of HBV through routine infant vaccination. HBV infection is the most common cause of chronic liver diseases and hepatocellular carcinoma in Korea. After hepatitis B vaccine era, seroprevalence of hepatits B surface antigen is decreasing, particularly in children. Hepatitis B vaccine is remarkably safe and shows high immunogenicity. Universal childhood immunization with three doses of hepatitis B vaccine in the first year of life is a highly effective method for prevention and control of hepatitis B.

Timing of hepatitis B vaccination: its effect on vaccine response in health care workers

We assessed the effect of timing and other biological variables on immune response among health care workers (HCW) vaccinated with hepatitis B vaccine. A total of 2.058 HCW received three doses and were tested for anti-HBs within 6 months. 92.2% of the HCW had evidence of seroprotection. Multivariable analysis showed that controlling for age, the estimated non-response OR associated with a delayed second dose was 2.16 (95% CI: 1.46, 3.18, p=0.004). We found a decreasing response rate with increasing age. Particular attention should be given to those HCW who are late for the second vaccine dose and to older subjects.