Community Medicine, National Research Center, Cairo, Egypt.
Pediatrics, National Research Center, Cairo, Egypt.
Vaccine. 2016 Apr 7;34(16):1904-8. doi: 10.1016/j.vaccine.2016.02.050. Epub 2016 Feb 28.
To evaluate the response to second vaccination series among post-booster sero-negative children who had previously received compulsory HBV vaccination.
After given a booster dose to 1070 children, 103 of them failed to generate anamnestic response (anti-HBs <10 IU/L). Only 91/103 children received additional two doses of recombinant HBV vaccine (i.e. 2(nd) vaccination series) after 1 and 6 months post-booster. Blood sample was withdrawn aseptically one month later for quantitative assessment of anti-HBs to detect development of protective immune response (≥10 IU/L). Immunological vaccination failure was assigned to children who did not develop protective immune response after 2(nd) vaccination series.
Protective immune response was detected among 84/91 children (92.3%). While 7/91 (7.7%) whose age were ≥10 years did not respond and had post-booster undetectable anti-HBs. About 80% of children with post-booster detectable anti-HBs showed significant protective immune response (anti-HBs ≥100 IU/L) and higher GMT (299.1 ± 3.6 IU/L) compared to those with undetectable 60% and 106.2 ± 12.9 IU/L respectively (P<0.05). No significant difference was detected as regards gender or residence, P>0.05. All children with history of rheumatic fever (7 children) or diabetes mellitus (1 child) developed immune response after 2(nd) vaccination series.
A booster dose of HB vaccine may be unable to induce sufficient immunological response in children who had undetectable anti-HBs titers. Revaccination for non-responders is an important procedure to increase HBV protection rate.
评估既往接受过乙型肝炎病毒（HBV）疫苗强制性接种且 booster 后血清学阴性的儿童对第二针系列疫苗的反应。
1070 名儿童接受 booster 剂量后，有 103 名儿童未产生回忆反应（抗-HBs <10 IU/L）。仅 91/103 名儿童在 booster 后 1 个月和 6 个月接受了另外两剂重组 HBV 疫苗（即第二针系列疫苗）。1 个月后无菌采血，定量评估抗-HBs，以检测保护性免疫反应（≥10 IU/L）的产生。将免疫接种失败定义为第二针系列疫苗接种后未产生保护性免疫反应的儿童。
91 名儿童中的 84 名（92.3%）检测到保护性免疫反应。然而，7/91（7.7%）年龄≥10 岁的儿童未产生反应，且 booster 后抗-HBs 无法检测到。约 80%的 booster 后抗-HBs 可检测到的儿童显示出显著的保护性免疫反应（抗-HBs≥100 IU/L）和更高的 GMT（299.1 ± 3.6 IU/L），与抗-HBs 不可检测的儿童（60%和 106.2 ± 12.9 IU/L）相比，差异具有统计学意义（P<0.05）。性别或居住地之间无显著差异，P>0.05。所有有风湿热（7 例）或糖尿病（1 例）病史的儿童在第二针系列疫苗接种后均产生了免疫反应。
HBV 疫苗 booster 剂量可能无法诱导 booster 后抗-HBs 滴度不可检测的儿童产生足够的免疫反应。对无反应者进行再次接种是提高 HBV 保护率的重要程序。
