Observational study of vaccine efficacy 14 years after trial of hepatitis B vaccination in Gambian children


Whittle, H; Jaffar, S; Wansbrough, M; Mendy, M; Dumpis, U; Collinson, A; Hall, A; (2002) Observational study of vaccine efficacy 14 years after trial of hepatitis B vaccination in Gambian children. BMJ, 325 (7364). p. 569. ISSN 1468-5833 DOI: 10.1136/bmj.325.7364.569

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Abstract

OBJECTIVE: To determine the duration of protection from hepatitis B vaccine given in infancy and early childhood. DESIGN: Cross sectional serological study of hepatitis B virus infection in children of various ages 14 years after the start of a trial of vaccination regimens. SETTING: Two villages in the Gambia. PARTICIPANTS: Children and adolescents given hepatitis B vaccine in infancy or early childhood: 232 were aged 1-5 years, 225 aged 5-9 years, 220 aged 10-14 years, and 175 aged 15-19 years. MAIN OUTCOME MEASURES: Vaccine efficacy against infection and against chronic infection in the different age groups. RESULTS: Vaccine efficacy against chronic carriage of hepatitis B virus was 94% (95% confidence interval 89% to 97%), which did not vary significantly between the age groups. Efficacy against infection was 80% (76% to 84%). This was significantly lower in the oldest age group (65%, 56 to 73). Of the uninfected participants in this age group, 36% had no detectable hepatitis B virus surface antibody. Time since vaccination and a low peak antibody response were the most powerful risk factors for breakthrough infection (P<0.001 in each case). Low peak antibody response was also a risk factor for chronic carriage (odds ratio 95, 19 to 466). CONCLUSIONS: Children vaccinated in infancy are at increased risk of hepatitis B virus infection in the late teens. The risk of chronic carriage after sexual exposure needs further assessment to determine if booster vaccines are necessary.

Item Type: Article
Keywords: Long-term efficacy, 12-year follow-up, virus-infection, villages, Adolescence, Adult, Carrier State, Child, Child, Preschool, Cross-Sectional Studies, Gambia, epidemiology, Hepatitis B Core Antigens, blood, Hepatitis B Surface Antigens, blood, Hepatitis B Vaccines, immunology, Hepatitis B, Chronic, epidemiology, immunology, prevention & control, Human, Infant, Prevalence, Regression Analysis, Time Factors, Treatment Outcome, Vaccination
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Vaccine Centre
Tropical Epidemiology Group
PubMed ID: 12228132
Web of Science ID: 178105200016
URI: http://researchonline.lshtm.ac.uk/id/eprint/16767

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