PEDIATRICS Vol. 103 No. 6 June 1999, pp. 1243-1247
Hepatitis B Vaccine Administered to Children and Adolescents at Yearly Intervals
Received Dec 3, 1997; accepted Dec 10, 1998.
,
From the * Department of International Health, Johns Hopkins
University School of Hygiene and Public Health, Baltimore, Maryland;
Drs. O'Donovan, Ahluwalia and Fertsch, Baltimore, Maryland;
§ Private Practice, Towson, Maryland; ¶ Hepatitis Branch, Division of
Viral and Rickettsial Diseases, National Center for Infectious
Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
and SmithKline Beecham Pharmaceuticals, Collegeville, Pennsylvania.
Objective. Hepatitis B vaccines are usually administered on a schedule of 0, 1 to 2, and 6 months. Longer intervals between the second and third doses have been studied, but the effectiveness of hepatitis B vaccine administered at intervals of >2 months between the first and second doses have not been studied. Our objective was to compare the antibody response in recipients of Engerix-B hepatitis B vaccine administered at 12-month intervals to the response to vaccine administered at 0-, 1-, and 6-month intervals.
Methods. A total of 389 children, 5 through 16 years of age, were randomized to receive Engerix-B (10 mg) at a schedule of either 0-, 1-, and 6-month intervals or 0-, 12-, and 24-month intervals. Blood was drawn before and 1 month after the third dose.
Results. Immediately before the third dose of vaccine,
92.3% of children who received vaccine on the 0-, 1-, and 6-month
schedule and 88.8% of children who received the 0-, 12-, and 24-month
schedule had antibody to hepatitis B surface (anti-HBs) antigen
concentrations 
10 mIU/mL. Of the children in the 0-, 1-, and 6-month
schedule, 95% received the third dose according to protocol versus
90% of those in the 0-, 12-, 24-month schedule. The geometric
mean anti-HBs concentration just before the third dose for recipients
of the 0-, 1-, and 6-month schedule (117.9 mIU/mL) was somewhat lower than that for the children who had received vaccine on the 0-, 12-, and
24-month schedule (162.1 mIU/mL). One month after the third dose,
>98% of all children had anti-HBs concentrations 10 mIU/mL and high
geometric mean antibody concentrations were observed in both groups:
5687 mIU/mL for children on the 0-, 1-, and 6-month schedule and 3159 mIU/mL for children on the 0-, 12-, and 24-month schedule. Body mass
index was correlated inversely with final antibody concentration, but
age was not a factor after adjustment for body mass index.
Discussion. Engerix-B administered on a 0-, 12-, and 24-month schedule is highly immunogenic. Providers should consider this alternate immunization schedule for children who are at low risk of immediate exposure to hepatitis B infections.vaccine, hepatitis B, hepatitis B vaccine, antigen, dose, schedule, immunization, adolescent. .
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