The comparison of different modifications which to be implemented hepatisis B virus vaccination with routine vaccination schedule of Turkey

This study is conducted in order to assess the effectiveness of hepatitis b vaccination which is added to the routine vaccination calendar of infants in Turkey since 1998. The study has three parts. The first part consists of 270 infants of 0-12 months who completed their first three doses in the community clinic (sağlık ocağı). 181 of them were vaccinated through the recommended schema (3rd, 6th and 9th month), 30 of them were vaccinated in the 5th, 10th and 13th, 13 of them in the 3rd, 4th and 10th month while the remaining 46 infants according to 11 different schemas. The antiHBs level in the serum sample one month after the last vaccination was measured by ELISA method. Nearly in all the infants, except for 3 of them, antiHBS level was found to be over 10 IU/L (Seroprotection rate 99%). In the second part, hepatitis b vaccination was administered to 20 infants in community clinic conditions in the 2nd, 3rd and 9th months, the first dose of which was given simulatenouly with BCG (Group I). AntiHBs titrates were measured one month after the last vaccination of the 50 infants (Group II) vaccinated in the 3rd, 4th and 9th months in the community clinic and of the 20 infants (Group III) vaccinated in the 0th, 1st and 6th month in the Medical School. Seroprotection was 100% at group I, 99% at group II and 100% at group III. AntiHBs titrate was found to be below 10 IU/L in one infant vaccinated in 3rd, 4th and 9th month. The geometric mean (p>0.05) of the antiHBs titrates one month after the last vaccination of the infants vaccinated inthe 2nd, 3rd, 9th and 0th, 1st, 9th months. In the group vaccinated in the 3rd, 4th and 9th month, the antibody level was higher compared to the other two groups (p<0.05). In the third part of the study, antiHBs levels of the three vaccination group after one year was measured. It was found that the geometric means of the antibody levels of the three groups were not different while they were lower than the levels after vaccination (p<0.05). The seroprotection rates continued to be 100%, 96% and 100% respectively. If HBV vaccination is administered simultaneously with other routine vaccinations or if the first dose together with BCG, it can provide a seroprotection as big as the schema of 0th, 1st, 6th month when applied without any accompanying vaccination. Vaccination shall be initiated in a very early period in Turkey where all pregnant women cannot be examined for HBV and which is mildy endemic for HBV. If impossible to apply in 0th, 1st, 6th or 0th, 2nd, 9th month, it can be applied 2th, 3rd and 9th.