Tram Huynh

Bio 1615-029

Intrucstor: Evelyn Susana Galvez

11/12/2014

Hepatitis B Vaccine With The Birth Dose Stored Outside The Cold Chain in Rural Viet Nam

Introduction

As I learned, “Hepatitis B is the world’s most common liver infection that can lead to cirrhosis and liver cancer later in life”. People who have hepatitis B, caused by the hepatitis virus, receiveattacks and injures their liver. It is transmitted through blood, sex or from mother to the newborn baby. Hepatitis B immunization is the most effective means for prevention of hepatitis B virus infection worldwide. In worldwide, we have at least 2 billion people have been infected with HBV, and about 400 million people have become “chronic carries” of the virus. It’s common in Asia, South Asia and South America. Viet Nam (VN) has 80 million people with high rate of chronic infection with the hepatitis B virus. Now, people are trying to introduce a hepatitis B vaccine across the nation. It’s dangerous for the infants who have high risk from exposure to the virus. The lower case Scientists wanted to make a successful immunization program, so they keep the vaccine in the cold chain. They did the project to produce low dose vaccines in VN because they wanted to make the vaccine outside the cold chain storage or refrigerated before to use at ambient temperature in rural areas. The hypothesis was success of this experiment when they evaluated success “in terms of the immunogenicity and protective efficacy of the vaccine.”

Material and Methods

Fieldwork was conducted from 1998 to 2000 and in different places, which were located in VN. They used the “Hepatitis B vaccine produced by the National Institute of Hygiene and Epidemiology (NIHE) in Hanoi”, Viet Nam. The national licensing authority said the vaccine was to be safe, immunogenic, and heat stable from them to have assessed the vaccine. Although the vaccine is being sold in dosage, there is no information about what lot of those vaccines were from. Scientists also did two different strategies to improve and introduce Hepatitis B vaccination to infants. Thesemethods that the scientists used were mostly analysis of specimens after disseverance on the evening of collection, and antibiotic at NIHE. The next technique used in data analysishad entered by two other persons and analyzed using data release 6, but it just applied in three infants who had three doses of thevaccine.They also did serologic and vaccination survey of venous blood from “1,106 infants, 9 –18 months of age, the entire reported birth cohort.”

Result

The study showed that large vaccines produced in rural Viet Nam, which were storage in ICC or OCC have similar functions. The results were shown in three different ways, showed prevalence test quantitatively for antibody hepatitis B were protected by level of serum to hepatitis B virus surface antigen. This assumption had turned out to be positive result by district and strategy. Table 2 showed the GMTs of antibody hepatitis B also showed the average highest and lowest temperatures in the two project districts.

Discussion

The result showed that scientists observed differences in the titers antibodies between various groups with a provided of more evidence for the immunogenicity of HepB vaccine after a period of storage at an ambient temperature. Three of results may or may not gave positive results because there are no differences of doses, which are produced or storage in ICC or OCC, however the temperature change would affect maintaining the vaccine. Surveys also indicatedthe infants were infected by their mothers at very early age in life, which affected the rate of response to the vaccine.The negative tests would prove that their blood did not have antibodies attached to their RBCs. In order to improve rates of birth dosing, it is requires not only the scientific justification, but also an appraisal of the benefits. These benefits may arise due to the right amount of evaluation and monitoring. But it could also cause many different risks, difficulties and costs.

Bibliography

  1. Hipgrave, David B. Maynard, James E. Big. “Improving birth dose coverage of hepatitis B vaccine/ Ameliorante de la couverturevaccinalecontre”, Bulletin of the Worth Health Organization, Jan 2006 issue.
  2. D.Davaalkham. “Administration of hepatitis B vaccine in winter as a significant predictor of the poor effectiveness of vaccination in rural Mongolia: evidence from a nationwide survey”. Journal of epidemiology & Community Health, 7/1/2007.
  3. Hipgrave, David B., Tran Trung, Huong Vu, Dat Do, Nga Nguyen, Long Hoang, Van Nguyen, Maynard James, Biggs Beverley “Immunogenicity Of A Locally Produced Hepatitis B Vaccine With The Birth Does Stored Outside The Cold Chain In Rural VietNam” Feb-2006