| Objectives:1.To evaluate the immunization effects of hepatitis B vaccines one year after vaccinated in healthly adults.2.To evaluate the immunization effects of different doses and different types of hepatitis B vaccine vaccinated at different immunization programs.Compare the dynamic change of anti-HBs,and the immunization effects of short and medium term.Methods:Adults 16~49 years were chosen,these adults should have completed the immunization of hepatitis B vaccine and the anti-HBs test was positive one month after the last vaccinate.One year after the third vaccinate,2m L blood was collected,and anti-HBs was detected by chemiluminescence immunoassay(CLIA).To evaluate the immunization effect of hepatitis B vaccine one year after vaccinated and its dynamic change combined with the data of one month after vaccination.The database was established with Epidata 3.2 and Excel 2003,and statistical analysis was performed with SPSS 13.0.Results:A total of 3312 subjects were selected in this study,and 2769 subjects completed the follow up,1090(39.36%)of these subjects were male.There were no statistically significant differences in age(F=0.982,P=0.299)or gender(?2=2.146,P=0.709)between the three different immunization programs.The positive rates of anti-HBs(anti-HBs?10m IU/m L)one year after the third vaccination were 67.85%,81.47%,69.47%,77.78%,80.92% and 78.74% respectively in the six different vaccines.The geometric mean concentration(GMC)of anti-HBs were 22.39 m IU/m L,69.73 m IU/m L,31.85 m IU/m L,56.12 m IU/m L,60.16 m IU/m L and 54.91 m IU/m L respectively.There differences between the six vaccines were statistically significant in positive rate(?2= 52.032,P<0.001)and GMC(F=18.651,P<0.001).Multiple comparisons found that the hepatitis B vaccine produced by Dalian Gaoxin Biological Products 10?g and Glaxo Smith Kline 20?g had a better immunization effects than other vaccines.The positive rates of anti-HBs one year after the thirdvaccination were 66.81%,76.85% and 78.63% respectively in the three different immunization programs,and the GMC of anti-HBs were 24.21 m IU/m L,46.17 m IU/m L and 58.99 m IU/m L respectively.The immunization effects of 0-1-12 month schedule were significantly higher than 0-1-3 month schedule(P<0.001),and the immunization effects of 0-1-6 month schedule were significantly higher than 0-1-3 month schedule partial(P<0.001).One year after the third vaccination,the different doses of hepatitis B vaccine have different immunization effects.Better responses were observed in young adults,especially in 10 ?g group.In 10 ?g group,the postive rate and GMC of anti-HBs were significantly higher in the 16~29 year group than in the 40~49 year group(P<0.05);there was no significant difference compared to20?g group(P> 0.05).The GMC of anti-HBs one year after the third vaccination had significantly declined compare to one month after the third vaccination(P<0.01).The correlation coefficient of the GMC of anti-HBs one month and one year after the last vaccination was 0.594(spearman,P<0.001).The correlation coefficient of age and GMC of anti-HBs one month was-0.085,and one year was-0.112(spearman,P<0.001).Conclusions:1.The immunization effect of six kinds of hepatitis B vaccine for adults was good;and compared the cost of different hepatitis B vaccine,hepatitis B vaccines domestic produced were recommended.2.In order to improve the compliance of adults in hepatitis B vaccine vaccination,a active immunization program should be established.0-1-3~12 month(the third vaccination is vaccinated at 3 to 12 months after the first vaccination)is recommended in adults.3.Different doses of hepatitis B vaccine was suitable for different age group,the 20 ?g dose could be used for all age adults and the 10 ?g dose can be used for young adults.4.Hepatitis B vaccine could achieve the same immunization effects in different genders.5.In order to obtain a better immunization effect,adults should be vaccinated the hepatitis B vaccine as soon as possible. |
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