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Pediatric Infectious Disease Journal:
Original Studies

Duration of Hepatitis B Immunity in Low Risk Children Receiving Hepatitis B Vaccinations From Birth

Petersen, Kenneth M. MD*; Bulkow, Lisa R. MS*; McMahon, Brian J. MD†; Zanis, Carolyn BS*; Getty, Marilyn RN*; Peters, Helen RN*; Parkinson, Alan J. PhD*

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Abstract

Background: The duration of protection after hepatitis B vaccination of infants is unknown.

Methods: We determined antibody to hepatitis B surface antigen (anti-HBs) at 4–13 years of age in 363 low risk children who had been vaccinated starting at birth with hepatitis B vaccine. Those with nonprotective titers (<10 mIU/mL) received a booster dose. We similarly followed 16 children of hepatitis B surface antigen (HBsAg)-positive mothers.

Results: Of low risk infants receiving a plasma-derived vaccine, 41% (42 of 102) of those whose primary response was unknown and 24% (4 of 17) who had initially responded retained protective titers (≥10 mIU/mL) of anti-HBs at 9 and 13 years, respectively. Of those who did not have protective antibody titers, 61% (33 of 54) and 67% (8 of 12), respectively, responded to a booster dose. In children of HBsAg-positive mothers, 31% retained protective anti-HBs at 12 years, and 90% (9 of 10) with nonprotective titers responded to a booster. In low risk children initially receiving a recombinant vaccine, 12.5% (26 of 208) and none (0 of 36) retained protective anti-HBs titers at 5 and 7 years of age, respectively. Of those who did not have protective titers, 90% (120 of 134) and 91% (32 of 35), respectively, responded to a booster.

Conclusions: Anti-HBs disappeared by 5 years of age in most children who were vaccinated with hepatitis B vaccine from birth. Although most children showed immunologic memory, one-third failed to demonstrate an anamnestic response to a booster dose. Additional long term studies of low risk infants are needed to determine duration of protection and the necessity for or timing of booster doses.

© 2004 Lippincott Williams & Wilkins, Inc.

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