From 1982 to 1989, 705 @entity1 born to HBsAg-positive mothers entered the @entity99 B vaccination program and received @entity1956 immunization in three randomized controlled trials testing variations in time of starting active vaccination, dose and type of vaccine, and number of @entity1956 immunoglobulin (HBIg) injections. A meta-analysis of individual @entity1 data of the three randomized trials was performed to determine which independent host and vaccination related factors influence protective efficacy and long-term immunogenicity, and to assess whether @entity1956 concomitant with standard DKTP vaccination provides optimal protection. Statistical methodology included multivariate logistic regression analysis. Eight @entity1 (1.1%), all born to HBeAg-positive mothers, became HBsAg carriers within the first year of life. The protective efficacy rate (PER) of passive-active immunization at 12 months follow-up was 92% for the total group of @entity1 from 114 HBeAg-positive mothers with no significant differences between @entity1 starting active immunization at birth or at 3 months of age, between @entity1 starting at 3 months of age receiving one or two doses of HBIg or between those receiving plasma derived or recombinant vaccine. The only factor that affected the PER significantly was the level of maternal @entity97 DNA; PER was 100% if maternal @entity97 DNA was < 150 pg ml-1 and 68% for @entity97 DNA levels > 150 pg ml-1. After 5 years of follow-up, the group that started active immunization at birth had significantly more @entity1 with loss of seroprotection (anti-HBs levels < 10 IU l-1, 15%) than the corresponding group starting at 3 months of age (anti-HBs < 10 IU l-2, 2%). One of 35 @entity1 with loss of seroprotection at 2 years became a HBsAg carrier in the fifth year of follow-up. This meta-analysis shows that the protective efficacy of @entity1956 vaccination is mainly influenced by material @entity97 DNA levels, and independent of the time of starting active vaccination at birth or at 3 months of age; long-term immunity was enhanced by starting active vaccination concomitant with DKTP vaccination. These findings allow incorporation of @entity1956 vaccine into the standard @entity1 immunization programs for countries with a passive-active immunization strategy for the control of @entity1956 . Additional measures are needed to protect neonates of highly viremic @entity1 .

Ten-year neonatal XXXX program, The Netherlands, 1982-1992: protective efficacy and long-term immunogenicity.

@entity1 :: ('9606', 'Species') :: ['women', 'children', 'patient', 'infants', 'infant'] @entity97 :: ('10407', 'Species') :: ['HBV'] @entity99 :: ('MESH:D056486', 'Disease') :: ['Dutch neonatal hepatitis'] @entity1956 :: ('MESH:D006509', 'Disease') :: ['passive-active hepatitis B', 'hepatitis B', 'hepatitis B vaccination']
@entity1956 :: (MESH:D006509,Disease) :: ['hepatitis B vaccination']
