Mass vaccination against hepatitis B in infants in Italy [letter]

A field trial currently underway in an area near Naples Italy where hepatitis B is endemic is providing support for a new vaccination protocol that involves administering hepatitis B vaccine at 3 and 5 months of age with a booster at 11 months. This protocol saves 1 dose of vaccine and also allows hepatitis B vaccine to be administered at the same time as immunization against diphtheria tetanus and poliomyelitis. Measurement of anti-hepatitis B surface antigen titers in the 110 Italian infants vaccinated according to this protocol to date revealed seroconversion rates of 93.6% immediately before the 11 month booster and 96.3% 2 months after the booster injection. In addition to being effective this protocol has been highly acceptable. 99% of mothers in the area have complied with the immunization program and have welcomed the opportunity to obtain protection for their children against hepatitis B at the same time that other immunizations are administered. On the basis of these findings the Italian health authorities have adopted the new protocol for routine use in areas highly endemic for hepatitis B infection. The World Health Organization has also recommended that hepatitis B vaccine be offered at the same time as other childhood immunizations.