Hepatitis B Clinical Trial
Official title:
The Hepatitis B Vaccine Booster Response Among the Youth Who Had Completed Neonatal Hepatitis B Vaccines
At the time of the present study, the necessity for booster vaccinations for the prevention of hepatitis B(HB) 15 years post-vaccination in the group of young adults who have become seronegative for HB markers after complete neonatal HB vaccination was in question. A booster vaccination strategy may lead to a significant economic impact on national health care resources, and the costs/benefits must therefore be carefully evaluated. Unfortunately, the data to support such analyses are lacking. Because an increased risk of HB infection is anticipated when adolescents enter into young adulthood through becoming sexual active, breakthrough infections such as fulminant HB might be the main concern instead of the risk of chronic HB carriage. To address this issue, this study aimed to measure the booster responses after HB vaccination in seronegative young adults who had completed neonatal HB vaccines in Taiwan before.
This cohort study was conducted between October 2007 and Jan 2009. The target population was
subjects aged 18-23 years who were born after 1984 when the Taiwanese national HB
vaccination program was launched. Their vaccination records must have shown a completed
neonatal HB vaccination, and they were seronegative for all three HB viral markers including
HBsAg(Hepatitis B surface antigen), anti-HBc(core antibody against Hepatitis B), and
anti-HBs(Surface antibody against Hepatitis B) within 2 years of entry into the study and at
study entry. They were recruited through a Student's Health Center Clinic referral, Bulletin
Board System posts, and Web-broadcast invitation. The neonatal HB vaccination records were
verified through linkage to the Taiwan Center for Disease Control databank. Signed informed
consent was obtained from all the participants and their parents or guardians. Pregnant
females, persons with a previous history of allergy to HB vaccines, or allergy to yeast were
excluded. First 3 months are screen phase to recruit college students for assay of hepatitis
B viral markers. Seronegative subjects were approached for enrollment into receiving
hepatitis B vaccine booster afterwards.
All participants were tested for HB markers at enrollment, even if they had been tested in
the previous months, to confirm their status. A questionnaire was completed at enrolment to
record sociodemographic factors including age, gender, self reported family history of
hepatitis B carriers, self reported blood type, and so on. The participants then received
three intramuscular doses of HB vaccine (Engerix-B, recombinant hepatitis B surface antigen,
20 microgram/ml/vial, GlaxoSmithKline, Belgium) at baseline and at the 1st and 6th month
follow-up visits. Their anti-HBs status was checked at baseline, 7-10 days, 1 month, 6
months, and 7 months following the first dose of HB vaccine. Adverse effects associated with
the vaccine were also reported within one week after each Engerix-B injection.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
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