Comparison of Hepatitis B Surface Antibody Levels After Vaccination With Combined One Dose of Hexavalent Vaccine and Two Doses of Pentavalent Vaccine Versus Three Doses of Pentavalent Vaccine

Pediatr Infect Dis J. 2024 Nov 1;43(11):e400-e405. doi: 10.1097/INF.0000000000004449. Epub 2024 Jun 24.

Abstract

Background: Vaccination can effectively prevent hepatitis B virus (HBV) infection. Vaccination with 3 doses of hexavalent HBV-containing vaccines led to a higher Hepatitis B surface antibody (anti-HBs) antibody level than vaccination with 3 doses of pentavalent HBV-containing vaccines. Whether the substitution of one dose of hexavalent HBV-containing vaccine in the pentavalent regimen could lead to a higher anti-HBs antibody level remains unknown.

Methods: A randomized, open-label controlled trial was conducted. Infants 30-120 days of age were randomly assigned to either a combined hexavalent/pentavalent regimen (hexavalent HBV-containing vaccine at 2 months of age and pentavalent HBV-containing vaccine at 4 and 6 months of age) or a 3-dose pentavalent regimen (pentavalent HBV-containing vaccine at 2, 4, and 6 months of age). Anti-HBs antibody levels were measured 3-6 months after the last vaccination.

Results: Seventy-six infants were enrolled, 38 in each group. The geometric mean of anti-HBs antibody levels in the combined hexavalent/pentavalent group was significantly higher than that of the 3-dose pentavalent group [316.2 mIU/mL (95% CI: 173.8-575.4 mIU/mL) versus 81.3 mIU/mL (95% CI: 38.9-169.8 mIU/mL), P = 0.006]. By multivariate analysis, the combined hexavalent/pentavalent regimen (coefficient 0.57; P = 0.003) was associated with higher anti-HBs antibody levels, while body weight <10th percentile (coefficient -0.85; P = 0.006) and receiving concomitant pneumococcal conjugated vaccines (coefficient -0.65; P = 0.001) were associated with lower anti-HBs antibody levels.

Conclusion: Substituting the first dose with a hexavalent HBV-containing vaccine in the pentavalent regimen for HBV vaccination led to higher anti-HBs antibody levels in infants. Concomitant pneumococcal conjugated vaccine administration may have an adverse impact on anti-HBs antibody level.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Female
  • Haemophilus Vaccines / administration & dosage
  • Haemophilus Vaccines / immunology
  • Hepatitis B Antibodies* / blood
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B Vaccines* / administration & dosage
  • Hepatitis B Vaccines* / immunology
  • Hepatitis B* / immunology
  • Hepatitis B* / prevention & control
  • Humans
  • Immunization Schedule
  • Infant
  • Infant, Newborn
  • Male
  • Vaccination
  • Vaccines, Combined* / administration & dosage
  • Vaccines, Combined* / immunology

Substances

  • Hepatitis B Vaccines
  • Hepatitis B Antibodies
  • Vaccines, Combined
  • Hepatitis B Surface Antigens
  • Haemophilus Vaccines

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