Integration of hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B virus, inactivated poliomyelitis and Haemophilus influenzae type b conjugate vaccine within existing national recommendations following a birth dose of monovalent hepatitis B virus vaccine: results of a systematic review in the Asia Pacific region

Expert Rev Vaccines. 2019 Sep;18(9):921-933. doi: 10.1080/14760584.2019.1646643. Epub 2019 Aug 1.

Abstract

Introduction: In Asia Pacific, most countries recommend a monovalent hepatitis B virus (HBV) vaccine dose at birth followed by primary vaccination series including three or four doses of combination vaccines against diphtheria, tetanus, and pertussis, with or without Haemophilus influenzae type b (Hib), HBV or poliomyelitis antigens. If hexavalent conjugate vaccines against diphtheria-tetanus-acellular pertussis-HBV-inactivated poliovirus-Hib (DTPa-HBV-IPV/Hib) replace the vaccines included in the primary vaccination series, co-administration of lower-valent vaccines would be avoided but infants would receive ≥4 doses of HBV-containing vaccines before the age of 2 years. Areas covered: We searched for clinical trials conducted in the South-East Asia and Western Pacific Regions (World Health Organization geographic definition), investigating vaccination regimens with >3 doses of HBV-containing vaccines in infants, including a monovalent HBV vaccine birth dose and ≥1 dose of GSK's hexavalent DTPa-HBV-IPV/Hib vaccine. Expert opinion: The six clinical trials included in this review showed that infants who received the monovalent HBV vaccine at birth and three or four doses of DTPa-HBV-IPV/Hib vaccine achieved protective immunogenic titers with a clinically acceptable safety profile. Our results support the integration of hexavalent DTPa-HBV-IPV/Hib vaccine within existing national recommendations in the Asia Pacific region to reduce the number of injections during infancy.

Keywords: Combination vaccine; DTPa-HBV-IPV/Hib; South-East Asia Region; Western Pacific Region; birth vaccination; hepatitis B vaccine; hexavalent vaccine; vaccination schedule.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Databases, Factual
  • Diphtheria / prevention & control*
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage
  • Haemophilus Infections / prevention & control*
  • Haemophilus influenzae type b / immunology
  • Hepatitis B / prevention & control*
  • Hepatitis B Vaccines / administration & dosage*
  • Hepatitis B Vaccines / immunology
  • Hepatitis B virus / immunology
  • Humans
  • Immunization Schedule
  • Poliomyelitis / prevention & control*
  • Tetanus / prevention & control*
  • Vaccines, Combined / immunology
  • Vaccines, Conjugate / administration & dosage
  • Vaccines, Conjugate / immunology*
  • Whooping Cough / prevention & control*

Substances

  • Diphtheria-Tetanus-acellular Pertussis Vaccines
  • Hepatitis B Vaccines
  • Vaccines, Combined
  • Vaccines, Conjugate