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      Comparison of the accelerated and standard vaccination schedules against hepatitis B in healthcare workers

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          Abstract

          Background:

          For healthcare workers, sometimes the conventional hepatitis-B virus (HBV) vaccination schedule might not provide seroconversion rapidly enough. The aim of this study was to compare the efficacy of conventional HBV vaccination with an accelerated schedule (days 0–1–21).

          Materials and Methods:

          In this randomized clinical trial, 161 healthcare workers were divided into two vaccination groups; group A underwent the conventional schedule (0–1–6 months) and group B received the accelerated program (0–10–21 days) of hepatitis B virus vaccine. The anti-HBs antibody was determined 30 days after completion of the third vaccine injection in both groups by enzyme immunoassay (EIA) (Abbot, Aux SYMsys). By using the Fisher’s exact and Wilcoxon tests, the results were analyzed. The protective level of anti-HBS was defined as titer ≥10 MIU/ml.

          Results:

          The seroprotection rate, 30 days after vaccination, were similar in both groups A and B; 96.3% of the participants in group A and 92.6% in group B had anti-HBS antibody ≥10 MIU/ml.

          Conclusion:

          Our data indicated that compared to the classic HBS vaccination program an accelerated schedule could also be effective and achieve seroprotection more rapidly.

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          Most cited references30

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          Immunological memory and protective immunity: understanding their relation.

          The immune system can remember, sometimes for a lifetime, the identity of a pathogen. Understanding how this is accomplished has fascinated immunologists and microbiologists for many years, but there is still considerable debate regarding the mechanisms by which long-term immunity is maintained. Some of the controversy stems from a failure to distinguish between effector and memory cells and to define their roles in conferring protection against disease. Here the current understanding of the cellular basis of immune memory is reviewed and the relative contributions made to protective immunity by memory and effector T and B cells are examined.
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            A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents.

            This report is the first of a two-part statement from the Advisory Committee on Immunization Practices (ACIP) that updates the strategy to eliminate hepatitis B virus (HBV) transmission in the United States. The report provides updated recommendations to improve prevention of perinatal and early childhood HBV transmission, including implementation of universal infant vaccination beginning at birth, and to increase vaccine coverage among previously unvaccinated children and adolescents. Strategies to enhance implementation of the recommendations include 1) establishing standing orders for administration of hepatitis B vaccination beginning at birth; 2) instituting delivery hospital policies and procedures and case management programs to improve identification of and administration of immunoprophylaxis to infants born to mothers who are hepatitis B surface antigen (HBsAg) positive and to mothers with unknown HBsAg status at the time of delivery; and 3) implementing vaccination record reviews for all children aged 11-12 years and children and adolescents aged <19 years who were born in countries with intermediate and high levels of HBV endemicity, adopting hepatitis B vaccine requirements for school entry, and integrating hepatitis B vaccination services into settings that serve adolescents. The second part of the ACIP statement, which will include updated recommendations and strategies to increase hepatitis B vaccination of adults, will be published separately.
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              Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States.

              We assessed the efficacy of an inactivated hepatitis B vaccine in a placebo-controlled, randomized, double-blind trial in 1083 homosexual men known to be at high risk for hepatitis B virus infection. The vaccine was found to be safe and the incidence of side effects was low. Within two months, 77% of the vaccinated persons had high levels of antibody against the hepatitis B surface antigen. This rate increased to 96% after the booster dose and remained essentially unchanged for the duration of the trial. For the first 18 months of follow-up, hepatitis B or subclinical infection developed in only 1.4 to 3.4% of the vaccine recipients as compared with 18 to 27% of placebo recipients (P < 0.0001). The reduction of incidence in the vaccinees was as high as 92.3%; none of the vaccinees with a detectable immune response to the vaccine had clinical hepatitis B or asymptomatic antigenemia. A significant reduction of incidence was already seen within 75 days after randomization; this observation suggests that the vaccine may be efficacious even when given after exposure.
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                Author and article information

                Journal
                J Res Med Sci
                J Res Med Sci
                JRMS
                Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences
                Medknow Publications & Media Pvt Ltd (India )
                1735-1995
                1735-7136
                October 2012
                : 17
                : 10
                : 934-937
                Affiliations
                [1]Nosocomial Infection Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
                Author notes
                Address for correspondence: Dr. Mandana Afsharian, Nosocomial Infection Research Center., Kermanshah University of Medical Sciences, Kermanshah, Iran. E-mail: mandana_afsharian@ 123456yahoo.com
                Article
                JRMS-17-934
                3698651
                23825992
                d98db2b2-c231-4e4b-889e-3534d93ea1b8
                Copyright: © Journal of Research in Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 January 2012
                : 01 July 2012
                : 13 July 2012
                Categories
                Original Article

                Medicine
                vaccination,hbs,hepatitis-b,healthcare workers
                Medicine
                vaccination, hbs, hepatitis-b, healthcare workers

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