Hepatitis B vaccination added to routine schedule

The hexavalent DTaP/IPV/HiB/HBV vaccine Infanrix hexa is replacing Infanrix-IPV+Hiv and Pediacel in the routine childhood immunisation schedule this autumn.

The introduction of Infanrix hexa into the routine childhood immunisation programme fulfils the WHO recommendation that every country should routinely immunise children against hepatitis B. | GSK

Infanrix hexa protects against hepatitis B in addition to diphtheria, tetanus, pertussis, poliomyelitis, and Haemophilus influenzae type b. It is now available to order on ImmForm.

As summarised in the MIMS routine vaccination table, Infanrix hexa should be given to infants born on or after 1 August 2017 at 8 weeks, 12 weeks and 16 weeks. Infants born before 1 August 2017 should receive Pediacel or Infanrix-IPV+Hib to initiate or complete their vaccination course.

Babies born on or after 1 August 2017 to mothers with hepatitis B will still require a dose of monovalent vaccine immediately after birth and at 4 weeks of age and should then follow the routine schedule with hexavalent vaccine (at 8, 12 and 16 weeks of age). They will require a further dose of monovalent hepatitis B vaccine at one year of age and should be tested to exclude infection at the same time.

A further dose of hepatitis B-containing vaccine at 3 years and 4 months is no longer recommended for children who have completed their routine primary immunisations with the hexavalent hepatitis B-containing vaccine.

Seroprotective antibodies

Immunogenicity of the new hexavalent vaccine was evaluated in infants from 6 weeks of age.

After a 3-dose primary vaccination schedule, at least 95.7% of infants had seroprotective or seropositive antibody levels against each of the vaccine antigens.

After a 2-dose primary vaccination schedule, the corresponding proportion was at least 84.3%.

Following a booster dose, the proportion increased to at least 98.4% with 3-dose primary vaccination and at least 97.9% with a 2-dose primary schedule.

The most commonly reported adverse reactions to the vaccine were loss of appetite, abnormal crying, irritability, restlessness, fever, local injection site swelling, fatigue, pain and redness.

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