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Critical Role of Hepatitis B Birth Dose Vaccination in Preventing Mother-to-Child Transmission
Preventing mother-to-child transmission (MTCT) is the cornerstone in global elimination of hepatitis B virus (HBV) infection because the risk of progressing from acute to chronic infection is 90% when HBV infection occurs in newborns. The risk of progressing from acute to chronic infection is 30-50% for children 1-5 years old. Effective prevention of MTCT involves a multi-step approach: (1) Screening of pregnant women for hepatitis B surface antigen (HBsAg), (2) Initiating antiviral (tenofovir) prophylaxis in HBsAg-positive pregnant women with high viremia (HBV DNA >200,000 IU/mL) at 28-32 weeks of gestation, (3) Administering birth-dose HBV vaccine (HepB-BD) and hepatitis B immune globulin (HBIG) to newborns within 24 hours of birth, and (4) Completing 3-dose HBV vaccine series (HepB3) as part of the Expanded Program for immunization starting at week 6
Effectiveness of Timely Hepatitis B Birth Dose Vaccination to Prevent Mother-to-Child Transmission in Ethiopia.
Authors conducted a multi-centre cross-sectional observational study in Ethiopia from May 2022 to June 2024. Analysis included 387 children born to HBV-positive, HIV-negative mothers who had completed routine HBV vaccination (HepB3). The median age of infant testing was 10 months (IQR 7.0-11). Overall MTCT risk was 5.2% (95% CI 3.4,7.8). MTCT was significantly lower among infants receiving HepB-BD alone (0/39, 0% [95% CI 0-9.0]) compared to those without immunoprophylaxis at birth (20/131, 15.3% [95% CI 10.1-22.4]) (p = 0.009). No transmission occurred with HepB-BD plus HBIg (0/217, 0% [95% CI 0-1.7]). Maternal viral load >200,000 IU/ml (AOR 16.6, 95% CI 4.82,57.19) and HBeAg positivity (AOR 4.21, 95% CI 1.08,16.44) were associated with increased MTCT risk amongst infants without immunoprophylaxis at birth. This study showed that vaccination series starting at 6 weeks is insufficient to prevent HBV mother-to-child transmission MTCT.
Congenital TORCH Infections and Neurodevelopmental Outcomes: A Cohort Study with Sibling Comparisons
Study used data from Swedish national health, birth, insurance, education, and death registers. 3,666,002 individuals born in Sweden between 1987 and 2021, including 975 who had TORCH (Toxoplasmosis, syphilis, rubella, cytomegalovirus, or herpes simplex) infections. TORCH infections were associated with intellectual disability and autism in population analyses and sibling comparisons, with markedly higher risks for severe intellectual disability and autism with co-occurring intellectual disability. This study found that congenital TORCH infections had associations with intellectual disability and autism, underscoring the importance of strengthening global vaccination programs and other preventive strategies.
The Platform Trial in COVID-19 Priming and BOOsting (PICOBOO): The Reactogenicity of Nine Licensed COVID-19 Vaccines Delivered in Immunocompetent Adults
PICOBOO is a randomised, Bayesian adaptive trial evaluating immunogenicity and reactogenicity of licensed COVID-19 vaccines in immunocompetent individuals aged >12 years. A total of 1,049 COVID-19 vaccine doses were administered to 586 adults enrolled between March 2022 and September 2024. Local reactogenicity ranged from 47% (110/236) with NVX-CoV2373 (Nvx) to 90% (131/145) with Moderna, while systemic reactogenicity ranged from 69% (162/236) with Nvx to 85% (121/143) with BNT162b2. Pain was the most common local reaction; headache, fatigue, myalgia, and chills were the most common systemic reactions. Severe reactogenicity events were rare. Interpretation: Reactogenicity events were common but rarely severe. Although reactogenicity appeared less frequent following Nvx than mRNA vaccines within strata
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