ACIP建议对HBV感染的母亲出生的婴儿进行单剂量再接种

StephenW

ACIP recommends single-dose revaccination for infants born to HBV-infected mothers
February 22, 2017

The Advisory Committee on Immunization Practices voted today in favor of a single-dose alternative to 3-dose revaccination for infants born to hepatitis B surface antigen-positive mothers who failed to respond to the initial hepatitis B vaccination series.

In a 13-1 vote, with one recusal, the committee approved the recommendation that HBsAg-negative infants with hepatitis B surface antibody levels <10 IU/L should be revaccinated with a single dose of hepatitis B vaccine, followed by post-vaccination serologic testing 1-2 months later.

“Infants whose antibody levels remain less than 10 IU/L following single-dose revaccination should receive two additional doses of vaccine, followed by retesting 1-2 months following the last dose,” Noele Nelson, MD, PhD, MPH, from the CDC’s division of viral hepatitis, said during the meeting.

Prior recommendations had instructed providers to order post-vaccination serologic testing, consisting of HBsAg and antibody to HBsAg for infants born to HBsAg-positive others at age 9-12 months, or 1-2 months following the final dose of the vaccine series if the series was delayed.

Data reviewed both by the Advisory Committee on Immunization Practices (ACIP) and its working group indicated that fewer vaccine doses would allow for shorter duration of case management and would be more cost-effective. However, the working group did note that having both single-dose and three-dose revaccination options would require additional provider/parent decision-making.

“Based on clinical circumstances or family preference, HBsAg-negative infants with hepatitis B surface antibody levels less than 10 IU/L may instead be revaccinated with a second complete three-dose series followed by post-vaccination serologic testing performed 1-2 months after the final vaccine,” Nelson said. “However, available data do not suggest a benefit for administering additional vaccines doses to infants who have not attained antibody levels greater than or equal to 10 IU/L following receipt of two complete vaccine series.” – by Bob Stott

Disclosure: The researchers report no relevant financial disclosures.

StephenW

ACIP建议对HBV感染的母亲出生的婴儿进行单剂量再接种
2017年2月22日

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免疫接种实践咨询委员会今天投票赞成针对未能对初始乙型肝炎疫苗接种系列作出反应的乙型肝炎表面抗原阳性母亲所生的婴儿使用单剂量替代3剂量再接种。

在13-1投票中，一次回避，委员会批准建议乙型肝炎表面抗体水平<10 IU / L的HBsAg阴性婴儿应该用单剂量的乙型肝炎疫苗再次接种，然后是接种后血清学测试1-2个月后。

“单剂量再次接种后抗体水平保持低于10 IU / L的婴儿应该接受两次额外剂量的疫苗，然后在最后一次给药后1-2个月再次测试，”Noele Nelson，MD，PhD，MPH，从CDC分裂病毒性肝炎，在会议上说。

以前的建议指示提供者在9-12个月，或在疫苗系列的最后剂量后1-2个月，对HBsAg阳性的其他人出生的婴儿进行疫苗接种后血清学检测，包括HBsAg和HBsAg抗体，如果系列延迟。

由免疫实践咨询委员会（ACIP）及其工作组审查的数据表明，减少疫苗剂量将允许病例管理的持续时间更短，并且更具成本效益。然而，工作组注意到，同时使用单剂量和三剂量再接种方案需要额外的供方/家长决策。

“根据临床情况或家庭偏好，乙型肝炎表面抗体水平低于10 IU / L的HBsAg阴性婴儿可以用第二个完整的三剂量系列进行再次接种，然后在1-2个月后进行接种后血清学检测最终疫苗，“纳尔逊说。 “然而，现有数据并不表明对于在接受两个完整的疫苗系列之后未达到抗体水平大于或等于10 IU / L的婴儿施用额外的疫苗剂量的益处” - 由Bob Stott

披露：研究人员报告没有相关的财务披露。