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Biomedical subjects

S Krugman

Publications and source records attributed to S Krugman.

At least 19 recordsLinked to original sources
PubMed1992

Hepatitis B vaccination in children: five year booster study.

AIM: to demonstrate that appropriate doses of hepatitis B vaccines would be protective for at least five years in children. This would be shown by administering booster doses and measuring the response. METHODS: 2 micrograms intramuscular (IM) doses of Merck Sharp and Dohme (MSD) recombinant DNA vaccine (rDNAV) were given to 318 children who had received age appropriate doses of MSD plasma derived vaccine (PDV) five years earlier. Sera were tested for hepatitis B virus (HBV) seromarkers pre- and postbooster. RESULTS: all children who had responsed to primary immunisation demonstrated an anamnestic response. The geometric mean titre (GMT) of antibody to hepatitis B surface antigen (antiHBs) rose from 89 to 4777 IU/L. AntiHBs was detected in 94% of vaccinees just prior to the five year booster, and 96.5% a mean of 10 days later. CONCLUSION: when initial vaccine seroconversion is satisfactory, protection of responders persists for at least five years, assuming that the response to vaccine boosters mimics the response to wild virus. Therefore, for population control of hepatitis B in children in endemic areas, booster doses are not required for at least five years.

Antibodies, Viral↗
PubMed1992

Inactivated hepatitis A vaccine: a safety and immunogenicity study in health professionals.

The safety and immunogenicity of an inactivated hepatitis A vaccine (HM175 strain) were evaluated in 150 seronegative health professionals. The age range was 21-65 years and the mean age was 30 years. The vaccine was administered at a dose of 720 ELISA units (EU) to 73 vaccinees at 0, 1 and 6 months, and to 77 vaccinees at 0, 1 and 12 months. The seroconversion rates were 88 and 90% in the two groups, respectively, one month after the first inoculation and 99 and 100% one month after the second inoculation. The geometric mean antibody titres were similar in both groups, exceeding 3000 mIU/ml one month after the third inoculation. The vaccine was well tolerated. The most frequent side effect was transient soreness at the site of the inoculation. No serious adverse reactions were observed. The study demonstrated that the HM175 inactivated hepatitis A vaccine was safe and highly immunogenic.

Adult↗
PubMed1992

The resurgence of measles in the United States, 1989-1990.

After almost a decade of relatively few reported cases, a major resurgence of measles occurred in the United States in 1989-1990. The increase primarily involved unvaccinated racial and ethnic minority children less than five years of age residing in inner-city areas. Outbreaks of measles among vaccinated school-aged children continued to occur but had less impact than outbreaks among preschool-aged children. Efforts to prevent measles must be aimed at improving age-specific measles vaccination coverage among preschool-aged children, and implementation of a two-dose measles strategy among school-aged children.

Adolescent↗
PubMed1992

Sexual abuse and corporal punishment during childhood: a pilot retrospective survey of university students in Costa Rica.

A sample of 497 students at the University of Costa Rica completed a survey on perceptions and experiences with various forms of punishment and experiences with sexual abuse during childhood. Spanking was shown to be the most widely accepted and most common form of discipline. The majority of the students considered most types of punishment forms of abuse. This study lacks a comparison group and cannot be generalized to the entire Costa Rican population. The section on sexual abuse demonstrated that 32% of the women and 13% of the men experienced some type of sexual abuse during childhood. The abuse mainly occurred between the ages of 5 and 10, and men were most often perpetrators.

Adolescent↗
PubMed1989

Mass vaccination against hepatitis B in preschool children: immunogenicity after three reduced doses.

The immunising effect of three reduced doses of Merck Sharp and Dohme (MSD) H-B Vax plasma derived vaccine delivered at monthly intervals was evaluated in 1225 four year old children. Eighteen children had evidence of previous or current infection with HBV. Of the remaining 1207 children, 1186 (98.3%) had antibody to hepatitis B surface antigen (anti-HBs) when tested by enzyme immunoassay (EIA). Levels of anti-HBs in 96 randomly selected sera were independently quantitated by radioimmunoassay (RIA) and all were positive for anti-HBs, with a geometric mean titre of 1013. There was no significant difference in seroconversion or anti-HBs levels between the groups of children nationwide. In 19 of the 39 centres, seroconversion was 100%. No centre had less than 92% seroconversion. This study confirms that three 2 microgram doses of MSD H-B Vax plasma derived vaccine given intramuscularly (IM) at monthly intervals are highly immunogenic in this paediatric population.

Child, Preschool↗
PubMed1988

Antibody responses to recombinant, yeast-derived hepatitis B vaccine in teenage New Zealand children.

Three groups of healthy teenage New Zealand children were given 2.5 micrograms, 5 micrograms and 10 micrograms, which is the currently recommended dose, of Merck Sharp and Dohme recombinant yeast-derived hepatitis B vaccine at time 0, 1 and 6 months and tested for antibody responses to vaccine and for other hepatitis B virus markers. Seroconversion rates exceeded 98% in all three groups. Geometric mean titres (GMT) of the anti-HBs increased with higher doses. There was no significant differences in GMT between the sexes. Under the conditions of this study, 2.5 micrograms doses of this vaccine induced an excellent antibody response in children 12-14 years of age.

Adolescent↗
PubMed1987

Yeast-recombinant hepatitis B vaccine. Efficacy with hepatitis B immune globulin in prevention of perinatal hepatitis B virus transmission.

A yeast-recombinant hepatitis B vaccine was licensed recently by the Food and Drug Administration and is now available. To assess the efficacy of the yeast-recombinant vaccine, we administered the vaccine in combination with hepatitis B immune globulin to high-risk newborns. If infants whose mothers were positive for both hepatitis B surface antigen and the e antigen receive no immunoprophylaxis, 70% to 90% become infected with the virus, and almost all become chronic carriers. Among infants in this study who received hepatitis B immune globulin at birth and three 5-micrograms doses of yeast-recombinant hepatitis B vaccine, only 4.8% became chronic carriers, a better than 90% level of protection and a rate that is comparable with that seen with immune globulin and plasma-derived hepatitis B vaccine. These data suggest that, in this high-risk setting, the yeast-recombinant vaccine is as effective as the plasma-derived vaccine in preventing hepatitis B virus infection and the chronic carrier state.

Carrier State↗
PubMed1987

Low-dose vaccination against hepatitis B in children: one-year follow-up.

Six hundred forty-three children, negative for markers of hepatitis B virus (HBV) infections, were given three X 2-micrograms doses of Merck, Sharp and Dohme (MSD) plasma derived hepatitis B vaccine (H-B-Vax) at monthly intervals. Twelve months after the first dose of vaccine, antibody to hepatitis B surface antigen (anti-HBs) was detected in 89% of children by radioimmunoassay (RIA) and in 83% by enzyme immunoassay (EIA). Seroconversion rates and anti-HBs titres were significantly greater in 1-4-year-olds than in older children (p less than 0.01). Eighteen children with no anti-HBs or other markers of HBV at this time were given 10 micrograms of vaccine and tested one month later. Seventeen developed anti-HBs, 12 at levels consistent with an anamnestic response. Forty-nine HBV-marker-negative children seroconverted for antibody to hepatitis B core antigen (anti-HBc) in the 8-month period before or the 12-month period following vaccination. Forty-six of these children were positive for anti-HBs, and one has been confirmed as a chronic carrier of hepatitis B surface antigen (HBsAg). Three cases of clinical hepatitis B in children have been seen in the community since the vaccination programme began. Two of these were amongst the estimated 5% of children who were not vaccinated. The third was in a vaccinee and occurred 4 1/2 months after the last dose of vaccine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Low dose hepatitis B vaccination in children.

One hundred and sixty-nine children negative for hepatitis B surface antigen (HBsAg) and antibody (anti-HBs), were given three doses of hepatitis B vaccine at monthly intervals. Doses were two micrograms or four micrograms given intradermally (ID) or intramuscularly (IM). All children were tested for HBsAg, anti-HBs and antibody to hepatitis B core antigen (anti-HBc) one month after the second dose of vaccine. Overall, 74% of children on two micrograms doses and 71% of children on four micrograms doses responded to two doses of vaccine by the production of anti-HBs. At this point, mass immunisation of other susceptible children was commenced. Four of 92 (4%) three to five year old subjects and 20 of 77 (26%) nine to 12 year olds were found to be anti-HBc positive alone, indicating prior infection. All 77 older children were further tested two months after the third dose of vaccine. All 20 who were anti-HBc positive, sero-converted for anti-HBs. Of the remaining 57, 52 (91%) produced anti-HBs at acceptable geometric mean titres (GMT). Three doses of two micrograms of H-B-VAX, given at monthly intervals were chosen for mass vaccination of high risk susceptible children in this mobile community, providing over 90% sero-conversion at low cost with a minimum of side effects.

Antibody Formation↗
PubMed1986

Recombinant yeast hepatitis B vaccine compared with plasma-derived vaccine: immunogenicity and effect of a booster dose.

The immunogenic effect of recombinant yeast and plasma-derived hepatitis B vaccines administered at 0, 1 and 6 months was evaluated in 334 seronegative health professionals. The seroconversion rates following 10 micrograms, 5 micrograms and 2.5 micrograms doses of recombinant vaccine were similar to those observed after 20 micrograms doses of plasma-derived vaccine. The geometric mean antibody titres (G.M.T.) induced by 10 micrograms and 5 micrograms doses of recombinant vaccine were similar to those observed after 20 micrograms doses of plasma-derived vaccine. The G.M.T. values were lowest after 2.5 micrograms doses of recombinant vaccine. However, the recipients of the 2.5 micrograms had a significant anti-HBs response after a fourth (booster) dose of recombinant vaccine was given at 12 months. A booster dose of recombinant hepatitis B vaccine was given to 31 health professionals who had been successfully immunised with plasma-derived vaccine 5-7 years previously. A significant anamnestic response was observed in 30 (97%) of these individuals in spite of the fact that 16 (52%) had low or undetectable levels of anti-HBs before the booster dose was given.

Adult↗