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- W2000343508 abstract "3 September 2001 Dear Editor UNIVERSAL NEONATAL IMMUNIZATION FOR HEPATITIS B I have questioned the rationale for the first neonatal dose of the four-dose universal Hepatitis B immunization programme, and have yet to find a satisfactory answer. The annotation by MacIntyre still doesn’t provide one.1 She acknowledges that Australia is an area of low endemicity, with perinatal transmission relatively uncommon (1% chronic carrier rate, resulting in 0.3% potential rate of vertical transmission).2 Antenatal screening for hepatitis B is routine in Australia, and for those uncommon situations where there has been no antenatal care, delivery would usually be in a hospital, where hepatitis B status would be routinely checked. Carrier mothers need to be identified, so that hepatitis B immunoglobulin can be given in addition to immunization. I have found no evidence indicating that a significant number of neonates have slipped through the net and have become chronic carriers. Such a situation might result from a falsely negative maternal screening test (theoretically 2% of tests, and so 0.02% of the population, translating to four cases per year in Victoria of which three would be prevented by active hepatitis B immunization alone).1 The current routine immunization programme, beginning at 2 months, has a high uptake rate, and so provides cover against hepatitis B beyond early infancy. Primary horizontal infection during the first months of infancy in Australia would be so rare that it wouldn’t be a significant risk factor. A follow-up study in the Netherlands found a significant loss of seroprotection in infants actively immunized from birth compared to those starting immunization at 3 months of age (15%vs 2% at 5 years with anti-hepatitis B < 10 IU/L), indicating a possible adverse outcome for neonatal immunization.3 One can only conclude that there is no logical basis for the first neonatal dose of the current four-dose regime. Excluding this dose would reduce costs ($10 per dose,2 or $600 000 per year in Victoria) without compromising the eradication of hepatitis B." @default.
- W2000343508 created "2016-06-24" @default.
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- W2000343508 date "2002-04-01" @default.
- W2000343508 modified "2023-09-25" @default.
- W2000343508 title "Universal Neonatal Immunization for Hepatitis B" @default.
- W2000343508 cites W2005953891 @default.
- W2000343508 cites W2109199630 @default.
- W2000343508 doi "https://doi.org/10.1046/j.1440-1754.2002.t01-2-00823.x" @default.
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