Jacob Puliyel1, Pathik Naik2, Ashish Puliyel3, Kishore Agarwal4, Vandana Lal5, Nimmi Kansal5, Devki Nandan6, Vikas Tripathi7, Prashant Tyagi7, Saroj K Singh8, Rajeev Srivastava9, Utkarsh Sharma10, V Sreenivas11. 1. Department of Pediatrics, St Stephens Hospital, Delhi, 110054, India. Puliyel@gmail.com. 2. Department of Pediatrics, Pathik Children's Hospital, Surat, India. 3. Consumer CAP HPI, London, UK. 4. Department of Pediatrics, Sardarmal Khandaka Memorial Hospital, Hathoj, Jaipur, India. 5. Department of Biochemistry, Dr Lal PathLabs, Rohini, Delhi, India. 6. Department of Pediatrics, PGIMER, Dr. RML Hospital, New Delhi, India. 7. Department of Pediatrics, Pt Madan Mohan Malaviya Hospital, Malaviya Nagar, Delhi, India. 8. Department of Pediatrics, Nazareth Hospital, Allahabad, India. 9. Department of Pediatrics, SGRRIM&S, SMI Hospital, Patel Nagar, Dehradun, India. 10. Department of Pediatrics, Thiranker Mahhavir Medical College, Muradabad, India. 11. Department of Biostatistics, All India Institute of Medical Science, Delhi, India.
Abstract
OBJECTIVE: In India, Hepatitis B vaccination is recommended at 6 wk except for hospital-deliveries. The authors examined protection afforded by the birth dose. METHODS: A case-control study was done. HBsAg and HBcAb were tested in 2671 children, 1 to 5 y and HBsAb was evaluated in a subset of 1413 children. Vaccination history was recorded. Cases were HBsAg carriers. In another analysis, children who got infected (HBsAg and/or HBcAb positive) were considered as cases. Exposed were the unvaccinated. In another analysis, exposed were those vaccinated without the birth dose. RESULTS: The odds ratio (OR) for HBsAg positivity with birth vaccination was 0.35 (95% CI 0.19-0.66); while with vaccination at 6 wk was 0.29 (95%CI 0.14-0.61), both compared to unvaccinated. Birth vaccination has no added protection when compared to the unvaccinated. Unvaccinated children in index study had HBsAg positivity of 4.38%. The number needed to treat (NNT) to prevent one case of HBsAg positivity was 32.6 (95% CI, 20.9 to 73.6). The odds of getting HBV infection was 0.42 (CI 0.25-0.68) with birth dose and 0.49 (CI 0.30-0.82) without the birth dose compared to the unvaccinated. Protective antibody (HBsAb) was present in about 70% of the vaccinated. In the unimmunised, in the first 2 y HBsAb protection was present in 40%. The odds ratio (OR) for HBsAb in the fully vaccinated between 4 and 5 y was 1.4 (95%CI 0.9-2.18) compared to the unvaccinated. CONCLUSIONS: The present study lends support to the pragmatic approach of the Government to vaccinate babies born at home starting at 6 wk.
OBJECTIVE: In India, Hepatitis B vaccination is recommended at 6 wk except for hospital-deliveries. The authors examined protection afforded by the birth dose. METHODS: A case-control study was done. HBsAg and HBcAb were tested in 2671 children, 1 to 5 y and HBsAb was evaluated in a subset of 1413 children. Vaccination history was recorded. Cases were HBsAg carriers. In another analysis, children who got infected (HBsAg and/or HBcAb positive) were considered as cases. Exposed were the unvaccinated. In another analysis, exposed were those vaccinated without the birth dose. RESULTS: The odds ratio (OR) for HBsAg positivity with birth vaccination was 0.35 (95% CI 0.19-0.66); while with vaccination at 6 wk was 0.29 (95%CI 0.14-0.61), both compared to unvaccinated. Birth vaccination has no added protection when compared to the unvaccinated. Unvaccinated children in index study had HBsAg positivity of 4.38%. The number needed to treat (NNT) to prevent one case of HBsAg positivity was 32.6 (95% CI, 20.9 to 73.6). The odds of getting HBV infection was 0.42 (CI 0.25-0.68) with birth dose and 0.49 (CI 0.30-0.82) without the birth dose compared to the unvaccinated. Protective antibody (HBsAb) was present in about 70% of the vaccinated. In the unimmunised, in the first 2 y HBsAb protection was present in 40%. The odds ratio (OR) for HBsAb in the fully vaccinated between 4 and 5 y was 1.4 (95%CI 0.9-2.18) compared to the unvaccinated. CONCLUSIONS: The present study lends support to the pragmatic approach of the Government to vaccinate babies born at home starting at 6 wk.
Entities:
Keywords:
Antibody to hepatitis B core antigen; Antibody to hepatitis B surface antigen; Hepatitis B core antigen; Hepatitis B surface antigen; Immunization; Passive immunity
Authors: Sandra Waaijenborg; Susan J M Hahné; Liesbeth Mollema; Gaby P Smits; Guy A M Berbers; Fiona R M van der Klis; Hester E de Melker; Jacco Wallinga Journal: J Infect Dis Date: 2013-05-08 Impact factor: 5.226
Authors: Dharmendra Kumar; Sharad Srivastava; M S Tevatia; Kanwaljit Kaur; Amit Sood; Manish Manrai; Reema Mukerjee Journal: Med J Armed Forces India Date: 2020-11-06