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Evaluation of the Protection Provided by Hepatitis B Vaccination in India

  • Original Article
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The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

In India, Hepatitis B vaccination is recommended at 6 wk except for hospital-deliveries. The authors examined protection afforded by the birth dose.

Methods

A case-control study was done. HBsAg and HBcAb were tested in 2671 children, 1 to 5 y and HBsAb was evaluated in a subset of 1413 children. Vaccination history was recorded. Cases were HBsAg carriers. In another analysis, children who got infected (HBsAg and/or HBcAb positive) were considered as cases. Exposed were the unvaccinated. In another analysis, exposed were those vaccinated without the birth dose.

Results

The odds ratio (OR) for HBsAg positivity with birth vaccination was 0.35 (95% CI 0.19–0.66); while with vaccination at 6 wk was 0.29 (95%CI 0.14–0.61), both compared to unvaccinated. Birth vaccination has no added protection when compared to the unvaccinated. Unvaccinated children in index study had HBsAg positivity of 4.38%. The number needed to treat (NNT) to prevent one case of HBsAg positivity was 32.6 (95% CI, 20.9 to 73.6). The odds of getting HBV infection was 0.42 (CI 0.25–0.68) with birth dose and 0.49 (CI 0.30–0.82) without the birth dose compared to the unvaccinated. Protective antibody (HBsAb) was present in about 70% of the vaccinated. In the unimmunised, in the first 2 y HBsAb protection was present in 40%. The odds ratio (OR) for HBsAb in the fully vaccinated between 4 and 5 y was 1.4 (95%CI 0.9–2.18) compared to the unvaccinated.

Conclusions

The present study lends support to the pragmatic approach of the Government to vaccinate babies born at home starting at 6 wk.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, St Stephens Hospital, Delhi, 110054, India

    Jacob Puliyel

  2. Department of Pediatrics, Pathik Children’s Hospital, Surat, India

    Pathik Naik

  3. Consumer CAP HPI, London, UK

    Ashish Puliyel

  4. Department of Pediatrics, Sardarmal Khandaka Memorial Hospital, Hathoj, Jaipur, India

    Kishore Agarwal

  5. Department of Biochemistry, Dr Lal PathLabs, Rohini, Delhi, India

    Vandana Lal & Nimmi Kansal

  6. Department of Pediatrics, PGIMER, Dr. RML Hospital, New Delhi, India

    Devki Nandan

  7. Department of Pediatrics, Pt Madan Mohan Malaviya Hospital, Malaviya Nagar, Delhi, India

    Vikas Tripathi & Prashant Tyagi

  8. Department of Pediatrics, Nazareth Hospital, Allahabad, India

    Saroj K. Singh

  9. Department of Pediatrics, SGRRIM&S, SMI Hospital, Patel Nagar, Dehradun, India

    Rajeev Srivastava

  10. Department of Pediatrics, Thiranker Mahhavir Medical College, Muradabad, India

    Utkarsh Sharma

  11. Department of Biostatistics, All India Institute of Medical Science, Delhi, India

    V. Sreenivas

Authors
  1. Jacob Puliyel
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  2. Pathik Naik
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  3. Ashish Puliyel
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  4. Kishore Agarwal
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  5. Vandana Lal
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  6. Nimmi Kansal
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  7. Devki Nandan
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  8. Vikas Tripathi
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  9. Prashant Tyagi
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  10. Saroj K. Singh
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  11. Rajeev Srivastava
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  12. Utkarsh Sharma
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  13. V. Sreenivas
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Contributions

This multicenter study was conceived by JP and designed originally by JP, PN, AP KA and VS. AP developed the computer architecture for data monitoring and VS helped with the statistical analysis. PN was responsible for study in Surat; DN, VT, PT, JP were responsible for study in Delhi centres; SKS and US for UP; RS for Uttarakhand. VL and NK were responsible for testing and interpretation of the test data.

The first draft was written by PN and it was finalised with critical inputs from each of the authors. AP was responsible for the write up on the computer programme used and he overlooks the data availability and will ensure it is available openly with no conditions attached.

Each author has seen the final draft, takes responsibility for its contents and signed the copyright transfer forms. JP will be the guarantor for the study report.

Corresponding author

Correspondence to Jacob Puliyel.

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Conflict of Interest

None.

Source of Funding

Indian Council of Medical Research, Delhi.

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Cite this article

Puliyel, J., Naik, P., Puliyel, A. et al. Evaluation of the Protection Provided by Hepatitis B Vaccination in India. Indian J Pediatr 85, 510–516 (2018). https://doi.org/10.1007/s12098-017-2601-0

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  • DOI: https://doi.org/10.1007/s12098-017-2601-0

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