Controlled trial of immune response of preterm infants to recombinant hepatitis B and inactivated poliovirus vaccines administered simultaneously shortly after birth
Nehama Lindera, Rachel Handsherc, Boris Germana, Lea Sirotaa, Mike Bachmana, Sigal Zingerb, Ella Mendelsonc, Asher Barzilaid
a Department of
Neonatology, Schneider Children's Medical Center of Israel, 14 Kaplan
St, Petah Tikva 49202, Israel, b Department of
Neonatology, The Chaim Sheba Medical Center, Tel Hashomer, and Sackler
School of Medicine, Tel Aviv University, Tel Aviv, Israel, c The Central Virology Laboratory, The
Chaim Sheba Medical Center, d Pediatric
Infectious Diseases, The Chaim Sheba Medical Center
Correspondence to: Dr Linder email: linder{at}netvision.net.il
Accepted 11 November
1999
AIM
The
study was conducted to evaluate the immunogenicity of an early, extra
dose of enhanced inactivated poliovirus vaccine (IPV) administered
simultaneously with recombinant hepatitis B vaccine (HBV) to preterm
infants shortly after birth.
METHODSThree
groups were studied. Fifty preterm infants received IPV intramuscularly
within 24 hours of birth, in addition to routine recommended childhood
immunisations. Fifty two preterm infants and 35 full term infants
received routine immunisations only (routine vaccination timing: HBV at
birth, 1 and 6 months of age; IPV at 2 and 4 months; oral polio vaccine
(OPV) at 4 and 6 months; diphtheria-tetanus-pertussis (DTP) at 2, 4, and 6 months; and Haemophilus influenzae B
vaccine at 2 and 4 months). Blood samples were taken at birth, 3 and 7 months of age from all infants, and at 1 month of age from preterm infants only.
RESULTSAt
birth, a lower percentage of both study and control preterm infants had
antipoliovirus type 3 titres 
1:8 than full term infants. At 1 and
3 months of age significantly more early IPV infants had antipoliovirus
type 3 titres 1:8 than routinely vaccinated preterm infants
(p < 0.05). At 7 months of age there were no significant differences
in percentage of antipoliovirus titres 1:8 or geometric mean times
(GMTs) between the early IPV group and the routinely vaccinated preterm
group. At 3 and 7 months of age, the percentage of positive
antihepatitis B titres ( 1:10) and the GMT of the early IPV preterm
group did not differ significantly from those of preterm controls.
There was no significant difference in percentage of positive
antihepatitis B titres between the early IPV group and full term
controls at any time. GMTs for hepatitis B antibodies were
significantly lower in the early IPV preterm group than in full term
controls at 3 and 7 months of age.
CONCLUSIONSAdministration
of an additional dose of IPV simultaneously with routine HBV to preterm
infants shortly after birth provides early protection from poliovirus
and hepatitis B infection, and does not interfere with poliovirus
antibody production at the age of 7 months.
Keywords: preterm infants; hepatitis B; poliovirus; vaccination; antibody
© 2000 by Archives of Disease in Childhood
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