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Duration of Immunogenicity and Efficacy of Hepatitis B Vaccine in a Yupik Eskimo Population
Robert B. Wainwright, MD;
Brian J. McMahon, MD;
Lisa R. Bulkow, MS;
David B. Hall, PhD;
Mary Anne Fitzgerald, MPH;
Annette P. Harpster, RN;
Stephen C. Hadler, MD;
Anne P. Lanier, MD;
William L. Heyward, MD
JAMA. 1989;261(16):2362-2366.
Abstract
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In 1981, a hepatitis B virus vaccine demonstration project was conducted in 1630 Yupik Eskimos in southwest Alaska. Levels of antibody to hepatitis B surface antigen and markers for hepatitis B virus infection in vaccinees were monitored yearly for 5 years. After 5 years of follow-up, 19% of those who initially had an immune response to vaccine of 10 sample ratio units or greater subsequently had levels of antibody to hepatitis B surface antigen lower than 10 sample ratio units. During the 5 years after the first dose of vaccine, in three responders and one person with an antibody to hepatitis B surface antigen response lower than 10 sample ratio units, antibody to hepatitis B core antigen developed, and the level of antibody to hepatitis B surface antigen was boosted. Hepatitis B surface antigen did not develop in any subjects, and none had clinical hepatitis. In the 5 years following the demonstration project, the annual incidence of hepatitis B virus infection decreased from 50 cases per 1000 population before the vaccine trial to 0.45 per 1000.
(JAMA. 1989;261:2362-2366)
Author Affiliations
From the Arctic Investigations Laboratory, Center for Infectious Diseases, Centers for Disease Control (Drs Wainwright, Hall, Lanier, and Heyward and Mss Bulkow, Fitzgerald, and Harpster), and the Alaska Native Medical Center, Alaska Area Native Health Service, Indian Health Service (Dr McMahon), Anchorage, Alaska; and the Hepatitis Branch, Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Ga (Dr Hadler).
Footnotes
Use of the trade name Heptavax is for identification only and does not imply endorsement by the Public Health Service or by the US Department of Health and Human Services.
Reprint requests to Arctic Investigations Laboratory, 225 Eagle St, Anchorage, AK 99501 (Dr Wainwright).
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