Halsey N A
Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21287.
Pediatr Infect Dis J. 1993 May;12(5):446-9. doi: 10.1097/00006454-199305000-00038.
The Committee on Infectious Diseases of the American Academy of Pediatrics and the Advisory Committee on Immunization Practices of the United States Public Health Service have revised the recommendations for hepatitis B control to include universal immunization of infants. Previous selective strategies targeting high risk groups for immunization have failed to prevent the significant morbidity and mortality associated with hepatitis B virus infection. The committees considered several alternative policy options before selecting universal immunization of infants as the most effective strategy for preventing the disease and its sequelae in the United States. More than 30 other countries have also adopted universal infant immunization programs. All children should receive three doses of vaccine by the time they are 18 months of age. Scheduling of the three doses is flexible. Two hepatitis B vaccines are currently available in the United States, and both are highly effective and safe. Dosage depends on several factors, including manufacturer, age at vaccination, maternal serologic status for hepatitis B surface antigen and presence of underlying disease. The committees continue to recommend immunization of high risk older children and adults, and immunization of adolescents is encouraged where resources are available.
美国儿科学会传染病委员会和美国公共卫生服务部免疫实践咨询委员会修订了乙肝控制建议，将婴儿普遍免疫纳入其中。此前针对高危人群的选择性免疫策略未能预防与乙肝病毒感染相关的严重发病和死亡情况。委员会在选择婴儿普遍免疫作为在美国预防该疾病及其后遗症的最有效策略之前，考虑了几种替代政策选项。其他30多个国家也已采用婴儿普遍免疫计划。所有儿童在18个月大时应接种三剂疫苗。三剂疫苗的接种时间安排很灵活。美国目前有两种乙肝疫苗，两者都高度有效且安全。剂量取决于几个因素，包括制造商、接种时的年龄、母亲乙肝表面抗原的血清学状态以及是否存在基础疾病。委员会继续建议对高危大龄儿童和成人进行免疫接种，并且在有资源的情况下鼓励对青少年进行免疫接种。
