IMMUNOGENICITY OF RECOMBINANT YEAST-DERIVED HEPATITIS-B VACCINE IN NONRESPONDERS TO PERINATAL IMMUNIZATION

Objective.-Nonresponse to hepatitis B vaccine in the perinatal period occasionally occurs. This report documents the results of reimmunizati on of nonrespenders to perinatal immunization. Design.-From a cohort o f 1154 infants immunized with plasma-based vaccine in the perinatal pe riod and followed up for more than 8 years, 45 nonresponders were iden tified. These children were reimmunized at 4 years of age. Each child received a yeast-derived recombinant hepatitis B vaccine on a 0-, 1-, and 5-month schedule, 33 children with 10-mu g and 12 with 5-mu g dose s. Blood was sampled 1 month after the third vaccination and thereafte r at 1, 2, and 4 years. Setting.-The follow-up clinic where the cohort of children was regularly seen. Patients.-Forty-five 4-year-old child ren who had no antibody to hepatitis B despite perinatal immunization. Main Outcome Measure.-Antibody levels to hepatitis B surface antigen. Results.-Seroconversion with titers higher than 10 mlU/mL occurred in all children. More than 70% still had titers higher than 10 mlU/mL 4 years after vaccination. Conclusion.-Nonresponders to perinatal hepati tis B vaccination respond well to subsequent vaccination.