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Abstract
Hepatitis A is an important public health issue worldwide. Hepatitis A vaccine (HepA) was first licensed in 1992. Both inactivated HepA (HepA-I) and live attenuated HepA (HepA-L) are highly immunogenic and well tolerated, and immune protection postvaccination can persist for at least 20 y. HepA is effective for both preexposure and postexposure prophylaxis, especially among children and young adults. The strategy of HepA vaccination varies in different countries and mainly includes vaccination among high-risk populations, regional childhood vaccination and universal childhood vaccination. The incidence of hepatitis A has decreased greatly in many countries in the last 30 y, but hepatitis A outbreaks frequently occur among high-risk populations and those who have not been covered by universal child vaccination programs in recent years. Disease surveillance and serosurveys are suggested to clarify the shift in the epidemiology of hepatitis A. The long-term persistence of immune protection after one dose of HepA should be further studied, as well as the cost-effective evaluation of different strategies of HepA vaccination. Based on this evidence, the recommendation on HepA vaccination should be put forward scientifically and updated in a timely and well-implemented manner.
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Affiliation(s)
- Li Zhang
- Academy of Preventive Medicine, Shandong University , Jinan, China.,Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention , Jinan, China
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Xu WB, Li Y, Li D, Fang Y, An ZJ, Teng X, Wang HQ, Shang QL. Investigation and analysis of antibody levels of hepatitis A among children before and after implementing the Expanded National Immunization Program in China. Vaccine 2019; 38:878-881. [PMID: 31733948 DOI: 10.1016/j.vaccine.2019.10.086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 09/29/2019] [Accepted: 10/26/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To analyze changes of hepatitis A antibody levels and immunization coverage of HAV vaccine among children before and after implementing the Expanded National Immunization Program in five counties of China, and to provide evidence for developing hepatitis A vaccine immunization strategies. METHODS 449 children born in 2001, 2005 and 2009 were selected from five counties for an immunization coverage and a sero-prevalence survey of hepatitis A. The chemiluminescence microparticle immunoassays (CMIA) were used to detect hepatitis A IgG antibody and analyzed the factors which influenced the immunization coverage and positive rates. RESULTS Among 449 subjects of children born in 2001, 2005 and 2009, the immunization coverage were 53.02%, 78.52% and 99.34% (χ2 = 91.285, P < 0.001). The positivity rates of hepatitis A IgG antibody were 61.07%, 81.21%, 95.36% (χ2 = 54.198, P < 0.001), respectively. The immunization coverage and positivity rate significantly increased with the delay of birth year. Children accepting different doses of HA vaccines are significantly different in positive rates of HA antibody, while there are no significant differences of different genders, years of birth, residence types, or types of registered permanent residence in different regions. The positivity rate increased significantly with administration of hepatitis A vaccine and shorter intervals between sample collection and HAV immunization. CONCLUSIONS After the Expanded National Immunization Program was implemented, hepatitis A antibody levels were significantly increased in five counties, which indicates a successful result of EPI.
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Affiliation(s)
- Wen-Bo Xu
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Yan Li
- Department of National Immunization Program, China Center for Disease Control and Prevention, Beijing 100050, China
| | - Di Li
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Yong Fang
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Zhi-Jie An
- Department of National Immunization Program, China Center for Disease Control and Prevention, Beijing 100050, China
| | - Xu Teng
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Hua-Qing Wang
- Department of National Immunization Program, China Center for Disease Control and Prevention, Beijing 100050, China.
| | - Qing-Long Shang
- Department of Microbiology, Harbin Medical University, Harbin, China.
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The impact of expanded program on immunization with live attenuated and inactivated Hepatitis A vaccines in China, 2004–2016. Vaccine 2018; 36:1279-1284. [DOI: 10.1016/j.vaccine.2018.01.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/12/2018] [Accepted: 01/16/2018] [Indexed: 01/11/2023]
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Rao S, Mao JS, Motlekar S, Fangcheng Z, Kadhe G. A review of immunogenicity and tolerability of live attenuated Hepatitis A vaccine in children. Hum Vaccin Immunother 2017; 12:3160-3165. [PMID: 27532370 PMCID: PMC5215502 DOI: 10.1080/21645515.2016.1216286] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Changing epidemiology of Hepatitis A virus (HAV) has led to an increased susceptibility of adolescents and adults to the infection. Vaccination can remarkably reduce the incidence and associated morbidity of HAV infection. This review is focused on the safety and efficacy of H2 strain derived live attenuated Hepatitis A vaccine. We found the vaccine to be highly immunogenic with minimal or negligible safety issues. Moreover, a single dose of live attenuated vaccine persists a long term immune response and can be a preferred option for developing countries. In 2014, Indian Academy of Paediatrics (IAP) also updated their recommendations for H2 vaccine as a single dose as against the previous 2 dose schedule. A focused approach to include the vaccine in national immunization program should be explored.
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Affiliation(s)
- Sameer Rao
- a Medical Affairs Department , Wockhardt Ltd , Bandra (East), Mumbai , India
| | - J S Mao
- b Institute of Viral Diseases, Zhejiang Academy of Medical Sciences , Hangzhou , China
| | - Salman Motlekar
- a Medical Affairs Department , Wockhardt Ltd , Bandra (East), Mumbai , India
| | - Zhuang Fangcheng
- b Institute of Viral Diseases, Zhejiang Academy of Medical Sciences , Hangzhou , China
| | - Ganesh Kadhe
- a Medical Affairs Department , Wockhardt Ltd , Bandra (East), Mumbai , India
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A Recombinant HAV Expressing a Neutralization Epitope of HEV Induces Immune Response against HAV and HEV in Mice. Viruses 2017; 9:v9090260. [PMID: 28914805 PMCID: PMC5618026 DOI: 10.3390/v9090260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 09/03/2017] [Accepted: 09/09/2017] [Indexed: 01/29/2023] Open
Abstract
Hepatitis A virus (HAV) and hepatitis E virus (HEV) are causative agents of acute viral hepatitis transmitted via the fecal–oral route. Both viruses place a heavy burden on the public health and economy of developing countries. To test the possibility that HAV could be used as an expression vector for the development of a combination vaccine against hepatitis A and E infections, recombinant HAV-HEp148 was created as a vector to express an HEV neutralization epitope (HEp148) located at aa 459–606 of the HEV capsid protein. The recombinant virus expressed the HEp148 protein in a partially dimerized state in HAV-susceptible cells. Immunization with the HAV-HEp148 virus induced a strong HAV- and HEV-specific immune response in mice. Thus, the present study demonstrates a novel approach to the development of a combined hepatitis A and E vaccine.
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Zhang Z, Zhu X, Hu Y, Liang M, Sun J, Song Y, Yang Q, Ji H, Zeng G, Song L, Chen J. Five-year antibody persistence in children after one dose of inactivated or live attenuated hepatitis A vaccine. Hum Vaccin Immunother 2017; 13:1-6. [PMID: 28319454 DOI: 10.1080/21645515.2016.1278329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
In China, both inactivated hepatitis A (HA) vaccine and live attenuated HA vaccine are available. We conducted a trial to evaluate 5-year immune persistence induced by one dose of inactivated or live attenuated HA vaccines in children. Subjects with no HA vaccination history had randomly received one dose of inactivated or live attenuated HA vaccine at 18-60 months of age. Anti-HAV antibody concentrations were measured before vaccination and at the first, second, and fifth year after vaccination. Suspected cases of hepatitis A were monitored during the study period. A total of 332 subjects were enrolled and 182 provided evaluable serum samples at all planned time points. seropositive rate at 5 y was 85.9% in the inactivated HA vaccine group and 90.7% in the live attenuated HA vaccine group. GMCs were 76.3% mIU/ml (95% CI: 61.7 - 94.4) and 66.8mIU/ml (95% CI: 57.8 - 77.3), respectively. No significant difference in antibody persistence between 2 groups was found. No clinical hepatitis A case was reported. A single dose of an inactivated or live attenuated HA vaccine at 18-60 months of age resulted in high HAV seropositive rate and anti-HAV antibody concentrations that lasted for at least 5 y.
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Affiliation(s)
- Zhilun Zhang
- a Tianjin Center for Disease Control and Prevention , Tianjin , China
| | - Xiangjun Zhu
- a Tianjin Center for Disease Control and Prevention , Tianjin , China
| | | | - Miao Liang
- a Tianjin Center for Disease Control and Prevention , Tianjin , China
| | - Jin Sun
- a Tianjin Center for Disease Control and Prevention , Tianjin , China
| | - Yufei Song
- b Sinovac Biotech Co., LTD. , Beijing , China
| | - Qi Yang
- c Jixian county Center for Disease Control and Prevention , Jixian, Tianjin , China
| | - Haiquan Ji
- c Jixian county Center for Disease Control and Prevention , Jixian, Tianjin , China
| | - Gang Zeng
- b Sinovac Biotech Co., LTD. , Beijing , China
| | - Lifei Song
- b Sinovac Biotech Co., LTD. , Beijing , China
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Zhang X, An J, Tu A, Liang X, Cui F, Zheng H, Tang Y, Liu J, Wang X, Zhang N, Li H. Comparison of immune persistence among inactivated and live attenuated hepatitis a vaccines 2 years after a single dose. Hum Vaccin Immunother 2016; 12:2322-6. [PMID: 27494260 PMCID: PMC5027719 DOI: 10.1080/21645515.2015.1134069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 12/02/2015] [Accepted: 12/16/2015] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Compare immune persistence from one dose of each of 3 different hepatitis A vaccines when given to school-age children: a domestic, live attenuated hepatitis A vaccine (H2 vaccine); a domestic inactivated hepatitis A vaccine (Healive®); and an imported, inactivated hepatitis A vaccine (Havrix®),. METHODS School-age children were randomized into 1 of 4 groups to receive a single dose of a vaccine: H2 vaccine, Healive®, Havrix®, or hepatitis B vaccine [control]. Serum samples were collected 12 and 24 months after vaccination for measurement of anti-HAV IgG using microparticle enzyme immunoassay. Seropositivity was defined as ≥ 20 mUI/ml. We compared groups on seropositivity and geometric mean concentration (GMC). RESULTS Seropositive rates for the H2, Healive®, Havrix®, and control groups were 64%, 94.4%, 73%, and 1.0%, respectively, 12-months post-vaccination; and 63%, 95.6%, 72%, and 1.0%, respectively 24-months post-vaccination. Seropositivity was greater for Healive® than for H2 and Havrix® at 12 months (p-values < 0.001) and 24 months (p-values < 0.0001). Average GMCs for the H2, Healive®, Havrix®, and control groups, in mIU/ml, were 29.7, 81.0, 36.4, and 2.9, respectively at 12 months, and 30.9, 112.2, 44.3, and 2.9, respectively, at 24 months. GMCs were greater for Healive® than for H2 and Havrix® at 12 months (p-values < 0.0001 and < 0.001, respectively) and 24 months (p-values < 0.001). No statistically significant differences in seropositivity or GMC were found within groups between 12 and 24 months. CONCLUSION Immunity persisted 24 months after a single dose of inactivated hepatitis A vaccine and live attenuated hepatitis A vaccine.
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Affiliation(s)
- Xiaoshu Zhang
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Jing An
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Aixia Tu
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xuefeng Liang
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Fuqiang Cui
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Zheng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Tang
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Jianfeng Liu
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xuxia Wang
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Ningjing Zhang
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Hui Li
- GanSu Provincial Center for Disease Control and Prevention, Lanzhou, China
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Ma F, Yang J, Kang G, Sun Q, Lu P, Zhao Y, Wang Z, Luo J, Wang Z. Comparison of the safety and immunogenicity of live attenuated and inactivated hepatitis A vaccine in healthy Chinese children aged 18 months to 16 years: results from a randomized, parallel controlled, phase IV study. Clin Microbiol Infect 2016; 22:811.e9-811.e15. [PMID: 27345175 DOI: 10.1016/j.cmi.2016.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 06/10/2016] [Accepted: 06/11/2016] [Indexed: 11/25/2022]
Abstract
For large-scale immunization of children with hepatitis A (HA) vaccines in China, accurately designed studies comparing the safety and immunogenicity of the live attenuated HA vaccine (HA-L) and inactivated HA vaccine (HA-I) are necessary. A randomized, parallel controlled, phase IV clinical trial was conducted with 6000 healthy children aged 18 months to 16 years. HA-L or HA-I was administered at a ratio of 1: 1 to randomized selected participants. The safety and immunogenicity were evaluated. Both HA-L and HA-I were well tolerated by all participants. The immunogenicity results showed that the seroconversion rates (HA-L versus HA-I: 98.0% versus 100%, respectively, p >0.05), and geometric mean concentrations in participants negative for antibodies against HA virus IgG (anti-HAV IgG) before vaccination did not differ significantly between the two types of vaccines (HA-L versus HA-I first dose: 898.9 versus 886.2 mIU/mL, respectively, p >0.05). After administration of the booster dose of HA-I, the geometric mean concentrations of anti-HAV IgG (HA-I booster dose: 2591.2 mIU/mL) was higher than that after the first dose (p <0.05) and that reported in participants administered HA-L (p <0.05). Additionally, 12 (25%) of the 48 randomized selected participants who received HA-L tested positive for HA antigen in stool samples. Hence, both HA-L and HA-I could provide acceptable immunogenicity in children. The effects of long-term immunogenicity after natural exposure to wild-type HA virus and the possibility of mutational shifts of the live vaccine virus in the field need to be studied in more detail.
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Affiliation(s)
- F Ma
- Jiangsu Provincial Centre of Disease Control and Prevention, Nanjing, Jiangsu Province, China
| | - J Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences, Kunming, Yunnan Province, China
| | - G Kang
- Jiangsu Provincial Centre of Disease Control and Prevention, Nanjing, Jiangsu Province, China.
| | - Q Sun
- Institute of Medical Biology, Chinese Academy of Medical Sciences, Kunming, Yunnan Province, China
| | - P Lu
- Jiangsu Provincial Centre of Disease Control and Prevention, Nanjing, Jiangsu Province, China
| | - Y Zhao
- Institute of Medical Biology, Chinese Academy of Medical Sciences, Kunming, Yunnan Province, China
| | - Z Wang
- Jiangsu Provincial Centre of Disease Control and Prevention, Nanjing, Jiangsu Province, China
| | - J Luo
- Institute of Medical Biology, Chinese Academy of Medical Sciences, Kunming, Yunnan Province, China
| | - Z Wang
- Xiangshui County Centre of Disease Control and Prevention, Jiangsu Province, China
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López-Gigosos R, Segura-Moreno M, Díez-Díaz R, Plaza E, Mariscal A. Commercializing diarrhea vaccines for travelers. Hum Vaccin Immunother 2014; 10:1557-67. [PMID: 24496054 PMCID: PMC5396228 DOI: 10.4161/hv.27737] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 12/28/2013] [Accepted: 01/05/2014] [Indexed: 11/19/2022] Open
Abstract
Continued growth in international travel and forecasts for a great increase in the number of people who travel from industrialized to emerging and developing countries make it necessary to develop and improve the capacity to provide health protection to travelers. Measures available to prevent some diseases include a currently limited number of marketed vaccines which represent extremely useful tools to protect travelers. Travelers very often experience diarrheal and gastrointestinal diseases for which some vaccines are available. Use of these vaccines should be evaluated based on traveler and travel destination and characteristics. Vaccines available include those against cholera, typhoid fever, hepatitis A, hepatitis E (only available in China), and rotavirus. The aim of this review is to provide an updated summary about each of the abovementioned vaccines that may be useful for making decisions regarding their use and assessing their indications in recommendations for travelers.
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Affiliation(s)
- Rosa López-Gigosos
- International Vaccination Center (IVC); Málaga, Spain
- Department Medicine Preventive and Public Health; University of Malaga; Malaga, Spain
| | | | | | - Elena Plaza
- International Vaccination Center (IVC); Málaga, Spain
| | - Alberto Mariscal
- Department Medicine Preventive and Public Health; University of Malaga; Malaga, Spain
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Wu JY, Liu Y, Chen JT, Xia M, Zhang XM. Review of 10 years of marketing experience with Chinese domestic inactivated hepatitis A vaccine Healive®. Hum Vaccin Immunother 2012; 8:1836-44. [PMID: 23032165 PMCID: PMC3656073 DOI: 10.4161/hv.21909] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 08/12/2012] [Accepted: 08/21/2012] [Indexed: 11/19/2022] Open
Abstract
In 2002, the first Chinese domestic preservative-free inactivated hepatitis A vaccine, Healive®, was introduced in China. It is highly immunogenic, and provides lasting protection in healthy individuals and generates protective levels of antibodies in other at-risk individuals. Over 10 years since its first licensure, postmarketing surveillance data have confirmed the outstanding safety profile of the vaccine. Comparative clinical trials indicated that Healive® induce equal or similar immunogenicity with other currently available inactivated hepatitis A vaccines and are interchangeable for the course of HAV immunization in Chinese children. The vaccine is effective in curbing outbreaks of hepatitis A due to rapid seroconversion and the long incubation period of the disease. Additional issues surrounding the use of the vaccine are also reviewed.
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Affiliation(s)
- Jun-Yu Wu
- Clinical Research Department, Sinovac Biotech Co. Ltd.; Beijing, P.R. China
| | - Yan Liu
- Clinical Research Department, Sinovac Biotech Co. Ltd.; Beijing, P.R. China
| | - Jiang-Ting Chen
- Clinical Research Department, Sinovac Biotech Co. Ltd.; Beijing, P.R. China
| | - Ming Xia
- Sales Department, Sinovac Biotech Co. Ltd.; Beijing, P.R. China
| | - Xiao-Mei Zhang
- Production Department, Sinovac Biotech Co. Ltd.; Beijing, P.R. China
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Zhang ZL, Zhu XJ, Wang X, Liang M, Sun J, Liu Y, Gao ZG, Wu JY, Dong XJ, Liu RK, Chen JT, Zhang YQ, Wang W, Zhang LP, Yin W. Interchangeability and tolerability of two inactivated hepatitis A vaccines in Chinese children. Vaccine 2012; 30:4028-33. [PMID: 22537990 DOI: 10.1016/j.vaccine.2012.04.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 03/23/2012] [Accepted: 04/09/2012] [Indexed: 10/28/2022]
Abstract
In China, no data are available to evaluate the interchangeability between Chinese domestic inactivated hepatitis A vaccines (Healive) and imported inactivated hepatitis A vaccines (Havrix). A double-blind, randomized controlled study was to compare interchangeability and safety of Healive and Havrix among Chinese children. Vaccine was administered to 303 healthy children at 0 and 6 months in one of four vaccine regimens: Healive-Healive; Healive-Havrix; Havrix-Healive or Havrix-Havrix. We collected sera samples at 0 (before vaccination), 6 (before second dose) and 7 months (after second dose), and compared groups in terms of proportion of sero-conversions which is defined as ≥ 20 mIU/ml, and geometric mean concentrations (GMCs) of anti-hepatitis A virus (HAV) antibody. Seroconversion rates were 133/133 (100%) for those received one dose of Healive and 105/131 (80.2%) for those received one dose of Havrix at 6 months, respectively (P<0.001), GMCs for Healive and Havrix were 126.1 and 40.9 mIU/ml (P<0.001), respectively. At 7 months, the seroconversion rate was 100% among all groups. The GMC after two doses of Healive was 8905.5 mIU/ml compared with 1900.9 mIU/ml after two doses of Havrix (P<0.001). The GMC in the Healive-Havrix group was 3275.8 mIU/ml compared with 4165.8 mIU/ml in the Havrix-Healive group (P=0.058). There is not different of reported adverse reactions across the groups. The present study indicated that both vaccines can be recommended for interchangeable using of immunization among Chinese healthy children.
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Affiliation(s)
- Zhi-Lun Zhang
- Tianjing Municipality Center for Disease Control and Prevention, Tianjing, China
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