a National Microbiology Laboratory , Public Health Agency of Canada , Winnipeg , Manitoba , Canada.
Hum Vaccin Immunother. 2018;14(8):2093-2097. doi: 10.1080/21645515.2018.1462428. Epub 2018 May 18.
Despite the long-term efficacy and immune persistence observed following HBV vaccination of infants, the need for a booster dose following infant immunization continues to be deliberated. Evidence from HBV booster dose response studies and long-term immunization program reviews are the basis for the recommendation that a vaccine booster is not necessary. However, further studies continue to emerge and highlight the need for standardization among observational studies in order to appropriately compare outcomes. There is an assumption that neonatal and infant (within 12 months of age) vaccine immune responses are equivalent; however, evidence exists for distinct vaccine responses within the first year of life. HBV vaccine programs have evolved over time, particularly regarding the type and dosage of vaccine used. Several universal neonatal immunization programs initially incorporated a 2.5 μg dosage (Recombivax-HB, Merck). This dosage has been shown in multiple long-term studies and meta-analyses to be associated with a lower primary response, decreased antibody persistence over time, and a reduced booster response 10 to 20 years following immunization. Ongoing surveillance of this and other HBV neonatally-vaccinated populations, particularly in low endemic regions, is necessary to understand the impact on long-term protection in order to ensure lifelong protection against hepatitis B infection.
尽管婴儿接种乙肝疫苗后可观察到长期疗效和免疫持久性，但对于婴儿免疫接种后是否需要加强剂量仍存在争议。乙肝加强剂量反应研究和长期免疫计划审查的证据为不建议接种加强剂量提供了依据。然而，不断有新的研究出现，强调需要对观察性研究进行标准化，以便能够对结果进行适当比较。人们假设新生儿和婴儿（12 个月龄内）的疫苗免疫反应是等效的；然而，在生命的第一年就存在着不同的疫苗反应证据。乙肝疫苗接种计划随着时间的推移而不断发展，尤其是关于所使用疫苗的类型和剂量。最初，有几个普遍的新生儿免疫计划采用了 2.5μg 剂量（Recombivax-HB，默克公司）。多项长期研究和荟萃分析表明，这种剂量与初次反应较低、抗体随时间的持久性下降以及接种后 10 至 20 年加强反应降低有关。对这种情况和其他新生儿接种乙肝疫苗的人群进行持续监测，特别是在低流行地区，对于了解对长期保护的影响是必要的，以便确保对乙型肝炎感染的终身保护。
