Concurrent Use of Hepatitis A, DTaP, Hib Vaccines Appropriate in Infants

[Guest guest]

>From Belkin

" GlaxoKline Biologicals, the maker of the hepatitis A virus vaccine,

funded this study and employs 4 of its authors "

http://www.medscape.com/viewarticle/544890

Concurrent Use of Hepatitis A, DTaP, Hib Vaccines Appropriate in Infants

CME

News Author: Laurie Barclay, MD

CME Author: Penny Murata, MD

Disclosure

September 21, 2006 Concurrent use of hepatitis A virus vaccine with

diphtheria-tetanus-acellular pertussis (DTaP) and Haemophilus influenzae

type b (Hib) vaccines was safe and immunogenic in children younger than 2

years, according to the results of a study reported in the September issue

of Pediatrics.

" In January 2006, the Centers for Disease Control and Prevention's Advisory

Committee on Immunization Practices published a recommendation for HAV

[hepatitis A virus] vaccination for all children in the United States at

age 1 year (12 - 23 months), " write Terry Nolan, MBBS, PhD, from the

University of Melbourne and Murdoch Children's Research Institute in

, Australia, and colleagues. " However, several other vaccines are

often administered to this age group, including measles, mumps, and rubella

vaccine; varicella vaccine; and booster doses of vaccines primed in the

first year of life. To maximize vaccination opportunities at office visits,

concomitant administration of these vaccines is needed and may help to

reduce immunization program costs and increase compliance with published

recommendations. "

This open, comparative, multicenter study evaluated the immunogenicity and

safety of a hepatitis A virus vaccine (Havrix; GlaxoKline Biologicals)

administered concomitantly with DTaP and Hib vaccines to 1084 healthy

children aged 11 to 25 months.

Based on age and previous vaccination history, the children were allocated

in a 4:4:3:3:4 ratio to 5 treatment groups. Infants 11 to 13 months of age

received 2 doses of hepatitis A virus vaccine 6 months apart (N = 243).

Those aged 15 to 18 months received 2 doses of hepatitis A virus vaccine 6

months apart (N = 241); or hepatitis A virus, DTaP, and Hib at month 0 and

the second dose of hepatitis A virus vaccine 6 months later (N = 183); or

DTaP and Hib at month 0 and hepatitis A virus vaccine at months 1 and 7 (N

= 175). Infants 23 to 25 months of age received hepatitis A virus vaccine

at months 0 and 6 (N = 242). The investigators measured immune responses at

baseline and 30 days after vaccine doses, and they collected information

regarding solicited and spontaneously reported adverse events.

After receiving 2 doses of hepatitis A virus vaccine, all infants in all of

the groups were seropositive. Coadministration of hepatitis A virus vaccine

with DTaP and Hib vaccines did not affect the immunogenicity of the 3

vaccines, except that the antipertussis toxoid vaccine response was

slightly decreased. Hepatitis A virus vaccine was well tolerated in

children aged 11 to 25 months.

" The administration of 2 doses of hepatitis A virus vaccine on a 0- and

6-month schedule starting at 11 to 13 months of age or at 15 to 18 months

of age was as immunogenic and well tolerated as the administration of 2

doses in children 2 years of age, " the authors write. " Immune responses to

DTaP and H. influenzae type b either given alone or coadministered with

hepatitis A virus vaccine were similar except for antipertussis toxoid

response. "

GlaxoKline Biologicals, the maker of the hepatitis A virus vaccine,

funded this study and employs 4 of its authors. Some of the other authors

have disclosed various relevant financial relationships with

GlaxoKline, Sanofi Pasteur, Wyeth, Abbott, Bristol-Myers/Squibb,

& , MedImmune, and/or Sanofi Aventis.

Pediatrics. 2006;118:e602-e609.

To earn CME credit, read the news brief along with the CME information that

follows and answer the test questions.

Release Date: September 21, 2006; Valid for credit through September 21,

2007

Credits Available

Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s) " for physicians;

Family Physicians - up to 0.25 AAFP Prescribed credit(s) for physicians

***

The material in this post is distributed without

profit to those who have expressed a prior interest

in receiving the included information for research

and educational purposes.For more information go to:

http://www4.law.cornell.edu/uscode/17/107.html

http://oregon.uoregon.edu/~csundt/documents.htm

If you wish to use copyrighted material from this

email for purposes that go beyond 'fair use', you

must obtain permission from the copyright owner.