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Hepatitis B
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PEDIATRICS Vol. 107 No. 5 May 2001, pp. 1065-1069

The Effect of Late Doses on the Achievement of Seroprotection and Antibody Titer Levels With Hepatitis B Immunization Among Adolescents

Received May 8, 2000; accepted Sep 5, 2000.

Amy B. Middleman*, Claudia A. KozinetzDagger , Laura M. Robertson§, Robert H. DuRantparallel , and S. Jean Emans

From the * Adolescent and Sports Medicine Section, and Dagger  Section of Academic General Pediatrics, Department of Pediatrics, Baylor College of Medicine, Houston, Texas; § Department of Pediatrics, College of Physicians and Surgeons, New York, New York; parallel  Section of General Pediatrics and Adolescent Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina; and the  Division of Adolescent/Young Adult Medicine, Harvard Medical School, Boston, Massachusetts.

Objective.  To determine the effect of varying dosing schedules and predictor variables on the seroprotection rates and geometric mean titer levels resulting from the hepatitis B vaccination series among adolescents.

Methods.  Adolescents received the hepatitis B vaccination series at varying schedules according to their natural adherence patterns. Data collected included participants' medication use; chronic illness; use of cigarettes, alcohol, and marijuana; age; race/ethnicity; and body mass index. Participants' dates of vaccinations were recorded and titer levels for hepatitis B surface antibody were drawn ~12 and 24 months after study enrollment. The data for 498 participants were analyzed using chi 2 tests, Student t tests, logistic regression models, and analysis of variance.

Results.  Seroprotection rates among adolescents were not affected by late vaccinations. The only factors affecting the achievement of seroprotection ~12 and 24 months after the first vaccination were body mass index and the number of immunizations received. Increased time between doses 1 and 2 and doses 2 and 3 showed a trend toward correlating with increasing titer levels.

Conclusions.  Although adolescents at risk of acquiring hepatitis B should receive the hepatitis B vaccination series in a timely fashion, late doses are not detrimental, and may be beneficial, to achieving high antibody levels against the hepatitis B virus.  Key words:  immunizations, adherence, body mass index.


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