Risk Factors Of Immunization Failure After Hepatitis B Vaccine In Neonates

Objective:The aims of present study were to investigate risk factors of immunization failure to hepatitis B vaccine of neonates in Pinghu City, and to analyze the present risk factors of the hepatitis B vaccine, and to actively avoid these possible risk factors of hepatitis B vaccine, and to strive to improve the effect of hepatitis B vaccine in the infant. The study provides our technical basis to prevent the neonate from hepatitis B virus (HBV) infection for practical immunization in the future.Methods:1, A1:1matched case-control study, matching the conditions as follows:age (<1year old), the same sex, the mother who infected with hepatitis B virus (HBV) in the same positive state before parturition such as HBsAg, HBeAg, anti-HBe, anti-HBc. 2、The inclusion criteria of immunization failure group:after neonates vaccinated three does of hepatitis B vaccine, to be tested the level of hepatitis B surface antibody (anti-HBs), if the anti-HBs titer being negative or anti-HBs titer<10IU/L, it was judged to be immunization failure, acknowledged as the overall immunization failure people, from which The research patients of immunization failure group were randomly selectedThe inclusion criteria of immunization successful group:after neonates vaccinated three does of hepatitis B vaccine, to be tested the level of anti-HBs, if the anti-HBs>100IU/L, it was judged to be immunization successful, acknowledged as the overall immunization successful people, from which the control groups of immunization successful group were randomly selected.3、All participants were investigated with a uniform questionnaire, which included a series of possible risk factors of influencing hepatitis B vaccine immunization response during the prenatal and postnatal.4、Single factor crosstabs analysis and multiple factor logistic regression analysis (Cox regression)were performed by SPSS16.0software. Statistical indicators:odds ratio (OR) and OR95%confidence interval (95%CI).Results:After single factor crosstabs analysis, and then multivariate logistic regression analysis, the results of statistical analysis showed that only three factors were entered in the model, such as:1) Not timely vaccinating the first dose of hepatitis B vaccine in neonates (OR=11.45,95%CI:2.54～51.63);2) Had diseases during0to7months of age such as recurrent severe influenza, pneumonia, frequent occurrence of viral or bacterial infection, as well as a clear diagnosis for immunocompromised, immunodeficiency, particularly humoral immunity, or other serious congenital diseases (OR=5.55,95%CI:1.91～16.17); 3) Infected with the virus, such as measles, chicken pox, measles, influenza before vaccinated hepatitis B vaccine or after that (during the incubation period of the disease, which was not too obvious to judged for vaccination contraindications)(OR=6.88,95%CI:1.70～27.79).Conclusion:Based on the present study, results indicated that the immunization failure related factors of hepatitis B vaccine in neonates had:not timely vaccinating the first dose of hepatitis B vaccine, and some immunity-related diseases during0to7months of age such as frequently occurrences of viral or bacterial infection, and being in the incubation period of the infection by virus before vaccinated hepatitis B vaccine or after that. It is suggested that we should actively avoid these factors during the hepatitis B vaccination of infants in order to improve the immunization effect, and suggested emphasis on re-vaccination after the initial immunization failure of hepatitis B vaccine in neonates.