Abstract:
Objectives: The knowledge about outcomes of infant vaccination against HBV infections using the DPT-HepB-Hib
vaccine in Ghana is limited. This study therefore investigated the levels of immunity to HBV among children who
received the DPT-HepB-Hib vaccine and HBsAg carriage in non-responders. Correlates for non-response or poor
response were also investigated.
Methods: Cross-sectional study. A major paediatric hospital in Accra. Four hundred and twenty four children between
the ages of 5 to 32 months who had completed the full vaccination schedule for the DPT-HepB-Hib vaccine.
Results: Of the 424 children, 358 (84.4%) developed anti-HBs while 340 (80.2%) developed ≥10 mIU/ml anti-HBs
(sero-protection) and 3 had HBsAg. A binary logistic regression analysis showed that younger children were associated
with sero-conversion (p=.022) and sero-protection (p=.021). For anti-HBs titres ≥100 mIU/ml age was a weaker
but significant contributor (p=.041), as compared to the number of vaccines from different manufacturers the child
used (p=.028). The mean age of those who used a single type of vaccine was higher (14.75 ± 6.056 months; n=268)
than those who used vaccines from two or more manufacturers (11.96 ± 4.645 months; n=156), p= <.001 (CI: -3.897
– 1.688), an indication that efforts to procure vaccine from same source when it was initially introduced are waning.
Conclusions: There is still a residual possibility of infection with HBV in spite of infant vaccination. In the light of
possible loss of anamnestic response over time, there is the need to consider a birth dose for HBV vaccination for all
neonates or booster dose for infants who may not have received the vaccine at birth. Using vaccines from a single
manufacturer is recommended.