Boosters of Hepatitis-B Vaccine may be needed!

Background: The duration of protection after hepatitis B vaccination of infants is unknown.
Methods: The researchers determined antibody to hepatitis B surface antigen (anti-HBs) at 4-13 years of age in 363 low risk children who had been vaccinated starting at birth with hepatitis B vaccine. Those with nonprotective titers (<10 mIU/mL) received a booster dose. They similarly followed 16 children of hepatitis B surface antigen (HBsAg)-positive mothers.
Results: Of low risk infants receiving a plasma-derived vaccine, 41% (42 of 102) of those whose primary response was unknown and 24% (4 of 17) who had initially responded retained protective titers (>=10 mIU/mL) of anti-HBs at 9 and 13 years, respectively. Of those who did not have protective antibody titers, 61% (33 of 54) and 67% (8 of 12), respectively, responded to a booster dose. In children of HBsAg-positive mothers, 31% retained protective anti-HBs at 12 years, and 90% (9 of 10) with nonprotective titers responded to a booster. In low risk children initially receiving a recombinant vaccine, 12.5% (26 of 208) and none (0 of 36) retained protective anti-HBs titers at 5 and 7 years of age, respectively. Of those who did not have protective titers, 90% (120 of 134) and 91% (32 of 35), respectively, responded to a booster.
Conclusions: Anti-HBs disappeared by 5 years of age in most children who were vaccinated with hepatitis B vaccine from birth. Although most children showed immunologic memory, one-third failed to demonstrate an anamnestic response to a booster dose. Additional long term studies of low risk infants are needed to determine duration of protection and the necessity for or timing of booster doses.( Pediatric Infectious Disease Journal. 23(7):650-655, July 2004.)

Low Birth Weight Infants and BCG Vaccination at Birth
In developing countries, low birth weight (LBW) children are often not vaccinated with Calmette-Guerin bacillus (BCG) at birth. Recent studies have suggested that BCG may have a nonspecific beneficial effect on infant mortality. We evaluated the consequences of not vaccinating LBW children at birth in Guinea-Bissau.
Conclusions: The policy of not vaccinating with BCG at birth had a negative impact on vaccination coverage for LBW children. Early BCG vaccination had no large negative impact on TST and BCG scarring. Mortality was lower for BCG-vaccinated than for unvaccinated LBW children controlling for available background factors. BCG vaccination of LBW children may have a beneficial effect on survival that cannot be explained by protection against tuberculosis. Future studies should examine possible adverse effects from equalizing BCG policy for LBW and NBW children. (Pediatric Infectious Disease Journal. 23(6):544-550, June 2004.)

Research on rotavirus vaccines continues as need remains pressing
The future of rotavirus vaccines includes both bovine-human reassortants and attenuated human rotavirus strains.
Rotavirus continues to be a major cause of morbidity in children, and a new and safe vaccine is sorely needed, said Paul A. Offit, MD, at the 16th Annual Infectious Diseases in Children Symposium: A Comprehensive Meeting for the Practicing Pediatrician.
In the United States, rotavirus accounts for about 2 million cases of diarrheal disease, 500,000 doctor visits, 55,000 hospitalizations and up to 40 deaths each year.
“One out of every 75 children born in this country will be hospitalized with dehydration secondary to rotavirus infection. So, there’s a significant amount of morbidity in this country,” said Offit, who is chief of the division of infectious diseases at Children’s Hospital of Philadelphia.
In the developing world, the need for a vaccine is even greater because rotavirus causes 660,000 to 800,000 deaths each year. “If you had to pick a single agent that kills more infants and young children than any other, it is rotavirus,” said Offit.