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Query: UMLS:C0019163 (hepatitis B)
 38,309 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Combining several vaccines in a single formulation can alleviate the increasing complexity of the paediatric vaccination schedule. However, vaccine antigens that are highly effective when administered singly may lose potency in combination; consequently, the efficacy of each component must be established for any new proposed combination vaccine. When the serological response to a vaccine correlates clearly with clinical efficacy, the efficacy of that component in a combination can be inferred from immunogenicity studies. Poliovirus, tetanus and diphtheria toxoids, Haemophilus influenzae type b and Neisseria meningitidis, and hepatitis B vaccines, can all be assessed in this manner. Unfortunately, the antibody titres induced by acellular pertussis vaccines do not correlate with vaccine efficacy. Thus, although diphtheria-tetanus-acellular pertussis (DTaP) vaccine has been considered a prime building block in the development of new combination vaccines, modifying DTaP by the addition of new vaccine components may decrease the ability of the vaccine to protect against pertussis without a change in serum antibody response. For this reason, immunogenicity is not an adequate or safe basis for licensing combination vaccines containing acellular pertussis. Development and licensing of new combination vaccines containing components with serological correlates of clinical efficacy can proceed more rapidly than DTaP-based combinations and should be pursued.
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PMID:Are serological responses to acellular pertussis antigens sufficient criteria to ensure that new combination vaccines are effective for prevention of disease? 927 76

A study of the immunogenicity of a recombinant hepatitis B vaccine was conducted among 385 Egyptian infants, 191 (49.6%) of whom were born to mothers with moderately active Schistosoma mansoni infection (mean egg count = 224 eggs/g of feces). All mothers were seronegative for hepatitis B surface antigen (HBsAg) and hepatitis B e antigen. Infants were vaccinated with a 2.5-microg dose of this vaccine, given along with diphtheria, tetanus, and pertussis (DTP) vaccine, at the ages of two, four, and six months. Serum samples taken from each infant at nine months of age were tested for HBsAg, antibody to hepatitis B core antigen, and quantitatively for antibody to hepatitis B surface antigen (anti-HBs). There was no significant difference (P = 0.1) between anti-HBs titers in infants of S. mansoni-infected mothers (mean = 539 mIU/ml) and in infants of noninfected mothers (mean = 377 mIU/ml). This study shows that there was no apparent effect of maternal schistosomiasis infection on the immune response of these infants to vaccination.
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PMID:Immunogenicity of recombinant hepatitis B vaccine among infants of mothers with active schistosomiasis. 928 16

In the introduction achievements of obligatory applied vaccines are described. Data on new vaccines for wide application are presented: acellular pertussis vaccine, Haemophilus influenzae b vaccine, hepatitis B vaccine and varicella (zoster) vaccine. For each vaccine data on immunity, protection and side effects are presented. Indications (epidemiological, illness severity) justifying vaccination as a method of protection from infection with a distinctive causative agent are presented. Antigen structure is given for each vaccine. Finally the form of application and age of primovaccination and revaccination are given. The conclusion is that these vaccines give high immunity and protection like those already in wide (obligatory) usage, and have less side effects.
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PMID:[New vaccines for wide usage]. 929 41

The aim of this single-blind, parallel trial was to assess whether the hepatitis B (HB) component of a DTPw-HB vaccine interferes with the immune response to the other three components when administered at 3, 5 and 7 months of age. One hundred and six infants were randomized to receive three doses of DTPw or DTPw-HB vaccines. Seroprotection (or seroresponse) rates and geometric mean titers (GMT) of antibodies were assessed 3-6 weeks after the third dose. Anti-diphtheria, anti-tetanus and anti-Bordetella pertussis antibodies were measured by ELISA and anti-HBs by radioimmunoassay. Local and general signs and symptoms were recorded for a 4-day follow-up period after each vaccination. After the full vaccination course all subjects in both groups had seroprotective titers (> or = 0.1 IU ml-1) against diphtheria and tetanus and seroresponded (titers > or = 15 EL.U ml-1) to B. pertussis, and there was no significant difference between groups in relation to GMT. All subjects vaccinated with DTPw-HB had seroprotective levels (> or = 10 mIU ml-1) of anti-HBs antibodies after the third dose (GMT of 2318 mIU ml-1). Overall there were no significant differences between groups in relation to the incidence of local and general symptoms. These results show that the HB component did not interfere with the immune response to the other three components of the vaccine.
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PMID:Hepatitis B component does not interfere with the immune response to diphtheria, tetanus and whole-cell Bordetella pertussis components of a quadrivalent (DTPw-HB) vaccine: a controlled trial in healthy infants. 930 54

The feasibility of a combined diphtheria-tetanus-acellular pertussis-hepatitis B (DTPa-HBV) vaccine was assessed and a comparison made of immunogenicity and reactogenicity to DTPa and HBV vaccines mixed in one syringe and to concomitant but separate injections as a primary vaccination course in three groups of infants at 3, 4.5 and 6 months of age. All subjects attained protective levels of anti-HBs antibodies 1 month after the primary course with higher geometric mean titres (GMTs) in the combined or mixed vaccinations. GMTs for pertussis toxin (PT), filamentous haemagglutinin (FHA) and pertactin (PRN) were as good or better in the groups administered the combined formulation and the extemporaneously mixed vaccines than the separate administration. No serious adverse event related to the vaccination was reported in this study. Neither the combined formulation of DTPa and HBV vaccines nor the extemporaneous mixture increased the incidence or severity of adverse reactions compared with the separate administration of DTPa. This study shows the feasibility of a combined DTPa-HBV vaccine and the data support, in the interim, the mixing of DTPa and HBV vaccines which are tested in clinical trials for infant immunization.
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PMID:Feasibility study of a combined diphtheria-tetanus-acellular pertussis-hepatitis B (DTPa-HBV) vaccine, and comparison of clinical reactions and immune responses with diphtheria-tetanus-acellular pertussis (DTPa) and hepatitis B vaccines applied as mixed or injected into separate limbs. 936

Health care workers may be exposed to a variety of infections as they carry out their job responsibilities. Guidelines have been issued for prophylaxis following exposure to blood or body fluids known to be infected with the human immunodeficiency virus. Hepatitis B vaccine must be offered to all workers who may be exposed to blood and body fluids. Chemoprophylaxis is not available for workers exposed to hepatitis C. Health care facilities must conduct a tuberculosis risk assessment, provide skin testing at least yearly and develop isolation procedures for potentially infectious patients. The Occupational Safety and Health Administration currently mandates two-stage skin testing for all new employees at risk for tuberculosis exposure who have not had a skin test in the past year. Recent skin-test converters should be evaluated for isoniazid prophylaxis after a chest radiograph rules out active tuberculosis. Workers should be removed from the workplace from days 10 to 21 following exposure to varicella infection; vaccination of nonimmune workers should be considered. Because of possible side effects, the standard pertussis vaccine is not used in adults, but a new acellular pertussis vaccine has been effective in this group.
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PMID:Occupational infections in health care workers: prevention and intervention. 940 14

We compared antibody levels following separate but simultaneous administration of diphtheria and tetanus toxoids with acellular pertussis vaccine (DTaP) containing pertussis toxoid, filamentous hemagglutinin, and pertactin (PRN); hepatitis B vaccine; and Haemophilus influenzae type b polysaccharide (polyribosylribitol phosphate; PRP) vaccine conjugated to tetanus toxoid (PRP-T) with those following administration of a combination of a DTaP-hepatitis B vaccine-PRP-T to infants at 2, 4, and 6 months of age. The antibody response to a booster dose of PRP conjugate vaccine (CRM197-OS) in infants with low (< 1 microgram/mL) or undetectable (< 0.10 microgram/mL) postpriming levels of antibody to PRP was also studied. Antibody levels were quantitated before and after dose 3 by enzyme-linked immunosorbent assay, radioimmunoassay, or neutralization assay. Seroresponse rates were not different between the two vaccine groups except for rates of response to PRP. There was a trend that levels of antibody to all the antigens included in the combination vaccine were lower than those of antibody to antigens in separate vaccines; for levels of antibody to diphtheria toxoid (P = .001), PRN (P < .0001), and PRP (P < .0001), the differences were significant. Despite low or undetectable postpriming levels of antibody to PRP, high-titered (geometric mean concentration, 9.02 micrograms/mL; range, 1.0-81.5 micrograms/mL), immunoglobulin G-predominant antibody to PRP was produced following a booster dose of CRM197-OS, a finding consistent with a memory response.
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PMID:Administration of combined diphtheria and tetanus toxoids and pertussis vaccine, hepatitis B vaccine, and Haemophilus influenzae type b (Hib) vaccine to infants and response to a booster dose of Hib conjugate vaccine. 943 82

Infants born to HBsAg- (hepatitis B surface antigen) carrier mothers are highly likely to become chronic hepatitis B (HB) carriers themselves unless their status is recognised at birth and they are immunised with three doses of HB vaccine, the first within 48 hours of birth, concurrent with hepatitis B immune globulin (HBIG). This study was designed to determine how many infants born in Victoria to carrier mothers completed three doses of HB vaccine. We sent the names of all infants of HBsAg-carrier mothers notified in Victoria between 1.7.91 and 30.6.92 to the appropriate local government immunisation providers and requested information on how many doses of HB vaccine, DTP (diphtheria-tetanus-pertussis) or CDT (combined diphtheria-tetanus), and OPV (oral polio vaccine) they had received. The HBsAg-carrier prevalence of women giving birth in Victoria in 1991-92 was at least 0.52%. Of the 336 infants notified, 239 (71.1%) were recorded in local government records. Of these 239, 90.8% received at least two doses and 80.8% received at least three doses of hepatitis B vaccine. There was no significant difference in the number who received three doses of HB vaccine compared with three doses of DTP or CDT vaccine. Of the entire cohort of 336, only 57.4% were documented as being completely immunised against hepatitis B. HB immunisation coverage for these infants needs to be improved. The high rate of loss to follow-up, especially between the maternity hospital and the community, is disturbing. Mechanisms for intensive prospective follow-up of these infants should be developed to prevent loss to follow-up and to encourage full immunisation against HB. Improving HB immunisation coverage of infants in high HBsAg-prevalence ethnic groups and introduction of universal infant HB immunisation may lead to increased coverage of infants of carriers by serving as back-up mechanisms for those lost to follow-up.
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PMID:Hepatitis B immunisation coverage of infants born to chronic carrier mothers in Victoria. 948 90

A retrospective cohort study was used to determine the extent to which immunisation visits due in the first year of life are split into separate visits. A one-month birth cohort of infants registered in early childhood health centres in the former Eastern Sydney Health Area was followed up when the infants were 8 to 11 months of age. A telephone questionnaire sought documented dates of each dose in the primary series of diphtheria-tetanus-pertussis (DTP), Haemophilus influenzae type b (Hib) and hepatitis B (HBV) vaccination. Of the 141 subjects, 130 had received all due doses of DTP and Hib vaccines and 63 (45 per cent) had been enrolled in the neonatal hepatitis B program. Infants in the latter group received the first DTP-Hib dose on average one week later than did those not in the hepatitis B program (DTP, P = 0.016; Hib, P = 0.047). The greatest percentage of missed DTP or Hib doses occurred in infants not receiving HBV vaccination (7.1 per cent of doses) or those high-risk infants enrolled in the neonatal hepatitis B program (2.9 per cent). Overall, 12 infants had 28 (6.9 per cent) of the 404 possible scheduled visits fragmented into two separate visits. In all cases, parents reported that this was at the suggestion of the general practitioner. We found no greater likelihood of fragmentation for infants who had also received hepatitis B vaccine. Only 17 infants (29 per cent) had received the third hepatitis B vaccine and DTP doses at the same visit, as recommended. These findings confirm anecdotal reports of fragmentation of scheduled visits and missed doses for infants due to receive multiple injections, and some delay in uptake among those receiving hepatitis B vaccine. Universal infant hepatitis B immunisation should not be considered until combination vaccines (which should also include a Hib component) become available in Australia.
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PMID:Fragmentation of scheduled visits and missed doses among infants receiving multiple injected vaccines. 948 91

Some major modifications of the recommended Swiss vaccination schedule have been introduced in spring 1996: 1. The vaccination against pertussis using the new acellular vaccines, which cause fewer side-effects. This allows the administration of a fourth and a fifth dose at the age of 2 and 4-7 years, respectively. 2. The consideration of combination vaccines, which contain the vaccinations against diphtheria, tetanus and pertussis as well as the vaccine against invasive diseases caused by Haemophilus influenzae type b. 3. In order to increase the individual vaccination protection, a second dose of MMR vaccine is recommended, preferably at the age of 4-7 years. A general recommendation for hepatitis B vaccination during adolescence may be expected in 1998.
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PMID:[Routine vaccination in childhood]. 949 11


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