Study of the safety, immunogenicity and seroconversion of a hepatitis-B vaccine in malnourished children of India

Lakshmi, G. Jyothi; Reddy, Prabhakar; Kumar, Kuldep; Bhavani, N.V; Dayanand, M

doi:10.1016/s0264-410x(99)00529-0

Cited by 13 publications

(7 citation statements)

References 15 publications

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“…However, the percentages of protected children were lower in the two countries among those children with moderate or severe malnutrition. These results are in accordance with recent studies that reported no immune response difference between healthy children and those with compromised nutritional status [18], [19], [20], [21].…”

Section: Discussionsupporting

confidence: 93%

Low Immune Response to Hepatitis B Vaccine among Children in Dakar, Senegal

et al. 2012

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HBV vaccine was introduced into the Expanded Programme on Immunization (EPI) in Senegal and Cameroon in 2005. We conducted a cross-sectional study in both countries to assess the HBV immune protection among children. All consecutive children under 4 years old, hospitalized for any reason between May 2009 and May 2010, with an immunisation card and a complete HBV vaccination, were tested for anti-HBs and anti-HBc. A total of 242 anti-HBc-negative children (128 in Cameroon and 114 in Senegal) were considered in the analysis. The prevalence of children with anti-HBs ≥10 IU/L was higher in Cameroon with 92% (95% CI: 87%–97%) compared to Senegal with 58% (95% CI: 49%–67%), (p<0.001). The response to vaccination in Senegal was lower in 2006–2007 (43%) than in 2008–2009 (65%), (p = 0.028). Our results, although not based on a representative sample of Senegalese or Cameroonian child populations, reveal a significant problem in vaccine response in Senegal. This response problem extends well beyond hepatitis B: the same children who have not developed an immune response to the HBV vaccine are also at risk for diphtheria, tetanus, pertussis (DTwP) and Haemophilus influenzae type b (Hib). Field biological monitoring should be carried out regularly in resource-poor countries to check quality of the vaccine administered.

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Section: Discussionsupporting

confidence: 93%

Low Immune Response to Hepatitis B Vaccine among Children in Dakar, Senegal

et al. 2012

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“…Although there are few published data describing the seasonality of nutritional status in urban Pakistan, it is unlikely that the variability of seasonally available foods will influence nutritional status in the population, and particularly in the urban poor. Studies looking specifically at vaccine response indicate that, while Ab production may be impaired in severe malnutrition (Powell 1982), in subjects with less severe nutritional deficiencies, there is no impact of nutritional status on Ab response to vaccination (Greenwood et al 1986;Lakshami et al 2000). Indeed, we have published elsewhere a detailed study to show that the Ab response to vaccination in rural Gambia is not related to nutritional status .…”

Section: Discussionmentioning

confidence: 99%

“…Studies looking specifically at vaccine response indicate that, while Ab production may be impaired in severe malnutrition (Powell 1982), in subjects with less severe nutritional deficiencies, there is no impact of nutritional status on Ab response to vaccination (Greenwood et al. 1986; Lakshami et al. 2000).…”

Section: Discussionmentioning

confidence: 99%

Effect of month of vaccine administration on antibody responses in The Gambia and Pakistan

Moore

Collinson

Fulford

et al. 2006

Tropical Med Int Health

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Summaryobjective To explore the relationship between calendar month of administration and antibody (Ab) response to vaccination in subjects from The Gambia and Pakistan, two countries with distinct patterns of seasonality.methods Three cohorts were investigated: Responses to rabies and pneumococcal vaccine were assessed in 472 children (mean age 8 years, males 53%) from rural Gambia. Responses to tetanus, diphtheria and hepatitis B (HBsAg) were investigated in 138 infants also from The Gambia (birth to 52 weeks of age, males 54%). Responses to rabies and Vi typhoid vaccines were assessed in 257 adults from Lahore, Pakistan (mean age 29.4 years, males 57%).results In Gambian children, significant associations were observed between month of vaccination and Ab response for the pneumococcal and rabies vaccines. As no consistent pattern by month was observed between the responses, it is assumed that different immunomodulatory stimuli or mechanisms were involved. In Pakistani adults, a significant pattern by month of vaccination was observed with both rabies and typhoid vaccine. No monthly influences were observed in the infant study to the tetanus, diphtheria or the HbsAg vaccines.conclusions Antibody responses to certain specific vaccines are influenced by month of administration. Further research is required to elucidate the precise mechanisms explaining these observations, but a co-stimulatory effect of seasonally variable environmental antigens is a likely cause. Future studies of Ab response to vaccination in countries with a seasonally dependent environment should consider month of vaccination when interpreting study findings.

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“…Early random measurements of immunoglobulins in children with severe PEM (kwashiorkor and marasmus) showed normal or increased levels, leading to the belief that the system was functionally intact, but high and variable levels of antigen exposure in such children make interpretation difficult (24). Studies that have tested the functional capacity of the immune system using a vaccine challenge have shown mixed results, with some studies showing no change in relation to nutritional status, whilst others show a decrease in response with malnutrition (6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

“…The effect that undernutrition has on the humoral immune response has been less consistently reported. Whilst early studies in small numbers of severely malnourished children reported an impaired response to selected vaccines (6), more recent studies in larger groups of children and in children with less severe nutritional deficiencies have reported no impact of nutritional status on antibody response to vaccination (7,8). Possible reasons for these divergent results include the difference between the strength and type of the vaccine challenge administered and the difference in the degree of malnutrition in the children studied.…”

mentioning

confidence: 97%

Impact of nutritional status on antibody responses to different vaccines in undernourished Gambian children

Moore

Green²,

Bates

et al. 2003

Acta Paediatrica

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Aim: To test the efficacy of T‐cell‐dependent and T‐cell‐independent vaccines in rural Gambian children suffering from a range of energy/protein and micronutrient deficiencies. Methods: Nutritional status (anthropometry, haemoglobin, plasma leptin and micronutrient status) and response to two vaccinations (23 valent pneumococcal capsular polysaccharide vaccine, Pneumo‐vax® and the Human Diploid‐Cell Rabies Vaccine) were assessed in 472 children aged 6½ to 9½ y. Results: Anthropometry and micronutrient status (as z‐scores against European reference values) indicated a range from moderate to severe levels of undernutrition [mean (interquartile range): weight‐for‐age z‐score –1.58 (–2.18 to –0.95); height‐for‐age z‐score –0.94 (–1.51 to –0.35); body‐mass‐index‐for‐age z‐score –1.43 (–2.05 to –0.84); mid‐upper arm circumference ‐1.41 (–1.72 to –1.13); leptin –1.06 (–1.10 to –1.03); haemoglobin (Hb) –0.30 (–1.18 to 0.79); zinc ‐1.29 (–2.42 to –0.55); vitamin C –0.01 (–1.18 to 1.15); retinol –1.33 (–1.97 to –0.77)]. A seasonal effect was observed in haemoglobin levels and in all micronutrients (with the exception of zinc and retinol) and in the response to vaccination. After adjusting for seasonality, age and gender, no consistent associations were found between any of the measures of nutritional status and the effectiveness of seroconversion to either of the vaccines. Conclusion: The successful short‐term seroconversion to whole inactivated viral and bacterial polysaccharide vaccines indicates that the processes leading to antibody secretion remain intact over a wide range of single and combined nutrient deficiencies.

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Study of the safety, immunogenicity and seroconversion of a hepatitis-B vaccine in malnourished children of India

Cited by 13 publications

References 15 publications

Low Immune Response to Hepatitis B Vaccine among Children in Dakar, Senegal

Low Immune Response to Hepatitis B Vaccine among Children in Dakar, Senegal

Effect of month of vaccine administration on antibody responses in The Gambia and Pakistan

Impact of nutritional status on antibody responses to different vaccines in undernourished Gambian children

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