A combination of hepatitis B vaccine and immunoglobulin does not protect all infants born to hepatitis B e antigen positive mothers.

In 42 infants of hepatitis B e antigen positive carrier mothers a randomised study of a low dose (5 micrograms) hepatitis B vaccine regimen starting within 24 hours of birth with or without hepatitis B immunoglobulin (0.25 ml/kg) showed that in the vaccine group 72% were antibody positive at the age of one year and in the vaccine plus immunoglobulin group 81%. In the vaccine group four of 18 infants were not protected and in those infants receiving vaccine plus immunoglobulin three of 21 were HBsAg carriers by 12 months of age. Hepatitis B vaccine either with or without concomitant HBIg did not protect all babies born of HBeAg positive mothers, from developing the HBsAg carrier status. Thus for full protection of all infants a more vigorous immunisation programme will be necessary.