[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-456982-105":59,"doc-detail-456982-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","increased-neonatal-vaccine-dose-or-booster-immunization-prevents-hepatitis-b-vaccine-breakthrough-infection","Increased neonatal vaccine dose or booster immunization prevents hepatitis B vaccine breakthrough infection","","Infants born to HBsAg/HBeAg-positive mothers remain at risk for hepatitis B vaccine breakthrough infection (VBI). This multicenter prospective cohort study evaluated whether higher neonatal hepatitis B vaccine dosing (20 μg vs. 10 μg) and/or booster immunization could reduce VBI through follow-up to age 5. The 20 μg group showed sustained higher anti-HBs and fewer seronegative cases, while boosters increased antibody levels in both dose groups. By age 5, the highest VBI incidence occurred in the 10 μg non-booster group, and overt/occult infections were confined to non-booster children. Multivariate analysis linked higher neonatal dose and booster immunization with reduced VBI risk, with the lowest risk when combined.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/increased-neonatal-vaccine-dose-or-booster-immunization-prevents-hepatitis-b-vaccine-breakthrough-infection/456982/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/increased-neonatal-vaccine-dose-or-booster-immunization-prevents-hepatitis-b-vaccine-breakthrough-infection/456982.png","ImageObject",300,407,{"name":92,"@type":93},"Valentina","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Which children were included in the study, and why are they at risk?","Question",{"text":112,"@type":113},"Infants were born to mothers positive for HBsAg and HBeAg. These infants remain at risk for hepatitis B virus vaccine breakthrough infection (VBI).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did neonatal vaccine dose and booster immunization affect anti-HBs levels?",{"text":117,"@type":113},"The 20 μg non-booster group maintained higher anti-HBs levels and lower seronegative rates at follow-ups than the 10 μg non-booster group. Booster immunization increased antibody levels in both dose groups.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main VBI findings by age 5?",{"text":121,"@type":113},"VBI incidence was highest in the 10 μg non-booster group. Overt and occult infections occurred among non-booster children, and the lowest VBI risk was observed when both higher neonatal dose and booster were combined.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},456982,1790864510,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},13056703020460,"https://ap-avatar.wpscdn.com/avatar/be000253dac470eee5d?_k=1778207105932848923","npj | vaccines Article  \nPublished in partnership with the Sealy Institute for Vaccine Sciences  \n[https://doi.org/10.1038/s41541-025-01327-2](https://doi.org/10.1038/s41541-025-01327-2)  \nIncreased neonatal vaccine dose or booster immunization prevents hepatitis B vaccine breakthrough infection in children from HBsAg and HBeAg positive mothers  \n Check for updates  \nYuchen Pan1,2,3, Yanhua Wu1, Jie Wang4,5, Zhifang Jia1, Yarong Song4, Yi Li4,6,7, Chong Wang8, Jie Li4  & Jing Jiang1,2,3   \nInfants born to HBsAg/HBeAg-positive mothers remain risk for hepatitis B virus vaccine breakthrough infection (VBI) . In this multicenter prospective cohort study, we assessed whether increased neonatal vaccine dose (20 μg vs. 10 μg) or booster immunization could reduce VBI among these children. Infants were vaccinated after birth and followed up to age 5. The 20 μg non-booster group sustained higher anti-HBs levels and lower seronegative rates at all follow-ups compared to the 10 μg nonbooster group. Booster immunization increased antibody levels in both dose groups. By age 5, VBI incidence was highest in the 10 μg non-booster group, whereas all overt/occult infections occurred among non-booster children. Multivariate analysis suggested that both higher neonatal dose and booster immunization were associated with a reduced VBI risk, with the lowest risk observed when both strategies were combined. These findings suggest that increased neonatal vaccine dose and booster immunization may help sustain anti-HBs and reduce VBI in high-risk population.  \nHepatitis B virus (HBV) remains a critical global health burden. In 2022, an estimated 254 million people were infected with HBV worldwide, with 1.1 million deaths primarily attributed to HBV-related cirrhosis and liver cancer1. The World Health Organization (WHO) adopted a global strategy aimed at eliminating viral hepatitis as a public health threat by 20302. Mother-to-child transmission represents a major route of HBV infection. Vaccination against HBV, administered starting at birth is the primary preventive measure recommended by the WHO3.  \nThe successful implementation of China’s HBV vaccination program serves as a notable example in HBV prevention. Since 1992, HBV vaccination has been implemented in newborns in China, and in 2002, it was included in the national childhood immunization schedule4. Prior to the program’s implementation, China ranked among the highest HBVprevalence countries globally. Notable reductions in HBV prevalence have been documented through program implementation. The prevalence  \nof hepatitis B surface antigen (HBsAg) in the general population decreased significantly from 9.75% in 1992 to 5.86% in 2020, whereas a dramatic decline from 9.7% to 0.3% was observed in children under 5 years of age5.  \nHowever, concerns persist regarding the long-term protective efficacy of the Hepatitis B vaccine (HB vaccine). Long-term follow-up studies in adults vaccinated during adulthood have demonstrated a gradual decline in hepatitis B surface antibody (anti-HBs) levels while immune memory is retained6,7. However, the immune response following infant immunization differs. Following birth-dose vaccination, seroprotective anti-HBs levels decline more rapidly in young children compared to adults8. Studies have indicated that a subset of vaccinated children fails to sustain adequate longterm anti-HBs levels, raising concerns about potential loss ofimmunological memory against HBsAg9, 10. As anti-HBs levels wane, particularly when falling below protective thresholds, the risk of vaccine breakthrough infection (VBI) increases. This risk is particularly increased in children born to  \n1Department of Clinical Epidemiology, the First Hospital of Jilin University, Changchun, China. 2Center of Infectious Diseases and Pathogen Biology, the First Hospital of Jilin University, Changchun, China. 3Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.","cbCaihkHBwdlSNvv","https://ap.wps.com/l/cbCaihkHBwdlSNvv","pdf",787663,"English","# Introduction\n## Hepatitis B burden and prevention\n## China’s HBV vaccination program\n## Rationale for dose escalation and boosters\n# Methods and cohort design\n## Study population\n## Vaccination strategies and follow-up\n## Immunologic and infection outcomes\n# Results\n## Anti-HBs persistence and seronegativity\n## VBI incidence and infection patterns\n## Subgroup and multivariate associations\n# Discussion and implications","[{\"question\":\"Which children were included in the study, and why are they at risk?\",\"answer\":\"Infants were born to mothers positive for HBsAg and HBeAg. These infants remain at risk for hepatitis B virus vaccine breakthrough infection (VBI).\"},{\"question\":\"How did neonatal vaccine dose and booster immunization affect anti-HBs levels?\",\"answer\":\"The 20 μg non-booster group maintained higher anti-HBs levels and lower seronegative rates at follow-ups than the 10 μg non-booster group. Booster immunization increased antibody levels in both dose groups.\"},{\"question\":\"What were the main VBI findings by age 5?\",\"answer\":\"VBI incidence was highest in the 10 μg non-booster group. Overt and occult infections occurred among non-booster children, and the lowest VBI risk was observed when both higher neonatal dose and booster were combined.\"}]","Increased neonatal vaccine dose or booster immunization prevents hepatitis B vaccine breakthrough infection | PDF",1790747849]