2585

WHEN TO GIVE A BOOSTER DOSE FOR HEPATITIS B VACCINED CHIL DREN IN EGYPT

EI Guindi M¹, Raouf A²; Alam A¹

¹Department of Pediatrics, Liver In Institute, Menoufiya University, Egypt

²Medical Biochemistry, Liver Institute, Menoufiya University, Egypt

Objective: Viral hepatitis is a major cause of morbidity and mortality. Hepatitis B and C account for more than 75 percent of all hepatitis. Hepatitis B vaccination has been implement ed in the Egyptian Extended Program for Immunization since 1995. The aim of this work is to study the , efficacy of this program and the need for further immunization schedule.

Methods: Three hundred neonates immediately after birth were included in the study. Half of them were given 0.5 ml of Engerix-B vaccine and the rest received 0.25 ml of the vaccine at birth, at one month and at six months of age. After 5 years these children were subjected to several investigations including HBcAg, HBs antibody, HBcAg, and HBeAg.

Results: Two hundred and eighty five child (90.5%)showed negative HBs antibodies while the other 30 children showed positive HBs antibodies at 5 years. Eighty seven of the non-immunized children were given 0.5 ml of the same vaccine to detect their immune response Originally 30 of these children received 0.25 ml vaccine at birth and the other 57 children received 0.5 ml vaccine at birth. After 45 days from this booster dose, anti-s was repeated. The results revealed that 44 children were converted to positive anti-s and the other 43 remained ant-s negative or non-immunized. The level of antibodies varied greatly in the converted group. Also, a higher number of this converted group was given originally 0.25ml of the vaccine at birth and later on at 1 and 6 months. Therefore, 90% of the vaccinated children showed non-detectable levels of anti-s after 5 years, and 50% of them are in need of more than one dose.

Conclusion: There is no difference between 0.25 and 0.5 ml vaccine dose for hepatitis B. All children should receive at least a booster dose of the hepatitis B vaccine at 5 years of age, as most of these children showed-ve anti-s even after one booster dose.