Elsevier

The Lancet

Volume 337, Issue 8744, 30 March 1991, Pages 747-750
The Lancet

ORIGINAL ARTICLES
Vaccination aginst chronic viral carriage in The Gambia

https://doi.org/10.1016/0140-6736(91)91367-4Get rights and content

Abstract

358 children in the Gambian villages of Keneba and Manduar, where hepatitis B virus (HBV) infection is endemic, were vaccinated with plasma-derived vaccine against HBV according to one of four regimens and followed for up to 4 years. Two regimens by which vaccine was injected intradermally into children between 0 and 4 years old led to peak geometric mean (95% Cl) concentrations of antibody against HBV surface antigen of 270 (202-358) and 555 (418-748) mlU/ml. The third regimen—intramuscular vaccination of children aged between 0 and 4 years—gave geometric mean peak antibody concentrations of 926 (765-1122) mlU/ml. A fourth regimen was intramuscular vaccination of children between 1 and 9 months old, which gave geometric mean antibody concentrations of 5431 (3903-75 456) mlU/ml. Despite these widely divergent responses and a 89% decay in antibody over the first 2 years, vaccination against HBV was 97% effective in preventing chronic infection. Vaccination was less effective in preventing uncomplicated infection: 5·3% of 264 vaccinees in Keneba and 19·1% of 94 vaccinees in Manduar tested positive for antibody to HBV core antigen. These "breakthrough infections" did not differ in frequency between regimens, and were associated with low initial antibody responses and chronic maternal carriage of HBV.

References (15)

There are more references available in the full text version of this article.

Cited by (106)

  • Antibody response to hepatitis B vaccine is independently associated with hepatitis B breakthrough infection among adults: Results from a three-year follow-up study in China

    2018, Vaccine
    Citation Excerpt :

    In recent years, antibody response to HepB has been further divided into four levels, including non-response (anti-HBs < 10mIU/ml), low response (10–99 mIU/ml), normal response (100–999 mIU/ml) and high response (≥1000 mIU/ml) [16,17]. Those who could not achieve normal and high response are sometimes suggested to administrate another three doses of HepB [17,18] because non-responders and low-responders have been reported to be more likely to be infected by HBV [8,9,19]. Although immune response after HepB vaccination and risk factors for HBV infection are different between children and adults, HBV breakthrough infection among adult HepB vaccinees are not well understood.

  • Hepatitis Vaccines and Immunoprophylaxis

    2010, GI/Liver Secrets Plus: Fourth Edition
  • Hepatitis B vaccination strategies tailored to different endemicity levels: Some considerations

    2010, Vaccine
    Citation Excerpt :

    Percentages of people with protective antibody levels induced by a three-dose vaccination series are lower when vaccination occurs at an older age (adults over the age of 40 years: >90% protection, by age 60 years or older: 65–75% protection) [2]. Antibody levels decrease over time after a primary three-dose vaccination series as is seen in follow-up studies in infants and children [10–17]. Results of a long-term follow-up study in a low endemic country for hepatitis B disease (Italy) showed that in 36% of the children vaccinated at infancy and 11% of the persons vaccinated at an adolescent age (recruits) anti-HBs antibody titers had dropped below the level correlated with protection 10 years after a primary series of three vaccinations [17].

  • Fractional dose of intradermal compared to intramuscular and subcutaneous vaccination - A systematic review and meta-analysis

    2020, Travel Medicine and Infectious Disease
    Citation Excerpt :

    The immunogenicity outcomes varied between studies. Although the majority of studies/study subgroups (n = 29) reported similar antibody responses after ID compared to IM/SC immunisation [17,90,92,94,96–99,101,103,105–108,110–112,114–121,124,126,129,130], a considerable number of studies found inferior antibody responses in the ID group compared to IM (n = 15) [91,93,95,100,102,104,109,112,113,122,123,125,127,128,131]. Nine out of ten studies on haemodialysis patients showed potential for dose-sparing with ID immunisation [92,96–98,113,114,121,124].

View all citing articles on Scopus
View full text