REVIEW - PROTECTIVE EFFICACY OF HEPATITIS-B VACCINES IN NEONATES

A literature search was carried out to investigate the factors that in fluence the protective efficacy (PE) of hepatitis B vaccines when give n to neonates of hepatitis B surface antigen and e antigen positive mo thers. Hepatitis B vaccines with either high or low antigen doses are very effective in preventing chronic hepatitis B infection in neonates at risk, but there is evidence that with lower dosages simultaneous u se of hepatitis B immune globulin (HBIG) administration is more import ant than with higher dosages to elicit good protection (PE greater tha n or equal to 90%). There is also a tendency for lower dosages to conf er high PE less consistently, with noticeably greater numbers of chron ic surface antigen carriers in neonates who received a complete vaccin ation course. Furthermore vaccination courses with higher vaccine dosa ges give high PEs, without concomitant HBIG administration at birth, p rovided that the first vaccine dose is given at birth and that the sec ond dose follows within 2 months. (C) 1994 Wiley-Liss, Inc.