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Studies on 3464 Infants of Hepatitis B Surface Antigen—Carrier Mothers

Hsu-Mei Hsu, MS, MPH; Ding-Shinn Chen, MD; Cheng-Hua Chuang, MD; Joseph Chih-Feng Lu; De-Min Jwo, RN; Chin-Chang Lee, MS; Hsing-Chi Lu; Shih-Hsiung Cheng; Yue-Fen Wang, MPH; Chinying Chen Wang, PhD; Kwang-Juei Lo, MD; Chun-Jen Shih, MD; Juei-Low Sung, MD

JAMA. 1988;260(15):2231-2235.

Abstract
To evaluate the efficacy of the mass hepatitis B vaccination program in Taiwan in interrupting perinatal hepatitis B virus transmission, 3464 randomly selected 18-month-old infant vaccinees born to hepatitis B surface antigen—carrier mothers were recruited from 9697 eligible infants during a six-month period of the program. They were divided into ten groups according to maternal infectivity and compliance with the vaccination schedule. Serum samples were tested for hepatitis B surface antigen, antibody to hepatitis B surface antigen, and antibody to hepatitis B core antigen. In 786 infants who had highly infectious mothers and who received hepatitis B immune globulin and vaccine on schedule, the protective efficacy was about 85%. The efficacy seemed to be slightly lower in those immunized off schedule. Overall, 11% of infants still carried hepatitis B surface antigen, and 81% of the infants had antibody to hepatitis B surface antigen that exceeded 10 mlU/mL in more than 90% of them. The geometric mean titers of antibody to hepatitis B surface antigen were more than 200 mlU/mL in every group of infants. We conclude that the mass vaccination program is efficacious in preventing perinatal hepatitis B virus transmission and the chronic carrier state; most infant vaccinees have adequate levels of protective antibody at 18 months of age. This program is extremely significant in the control of hepatitis B virus infection in Taiwan.

(JAMA 1988;260:2231-2235)

Author Affiliations
The Hepatitis Control Committee; The Hepatitis Steering Committee

From the Bureau of Disease Control and the Information Center, Department of Health (Mss Hsu, Jwo, and Wang, Drs Chuang and Shih, and Messrs J. C. Lu, Lee, H. C. Lu, and Cheng); Institute of Statistics, Academia Sinica (Dr Chen Wang); and the Science and Technology Advisory Group (Drs Chen, Lo, and Sung), The Executive Yuan, Taipei, Taiwan, Republic of China.

Footnotes
Reprint requests to Division of Epidemiology, Bureau of Disease Control, Department of Health, 100 Ai-Kuo East Rd, Taipei, Taiwan 10726, Republic of China (Ms Hsu).

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