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IMMUNOGENICITY OF A LOCALLY PRODUCED HEPATITIS B VACCINE WITH THE BIRTH DOSE STORED OUTSIDE THE COLD CHAIN IN RURAL VIETNAM

DAVID B. HIPGRAVEInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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TRUNG NAM TRANInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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VU MINH HUONGInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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DO TUAN DATInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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NGUYEN TUYET NGAInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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HOANG THUY LONGInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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NGUYEN THU VANInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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JAMES E. MAYNARDInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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BEVERLEY-ANN BIGGSInternational Health Unit, Burnet Institute, Alfred Medical Research and Education Precinct, Prahran, Victoria, Australia; Department of Medicine (Royal Melbourne Hospital/Western Hospital), University of Melbourne, Royal Melbourne Hospital, Parkville, Australia; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; Program for Appropriate Technology in Health, Hanoi, Vietnam

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The heat stability of hepatitis B vaccine (HepB vaccine) should enable its storage outside the cold chain (OCC), increasing access to the birth dose in areas lacking refrigeration. We compared the immunogenicity of a locally produced vaccine among infants who received three doses stored within the cold chain (n = 358) or for whom the first dose was stored OCC for up to one month (n = 748). Serum was collected from these infants at age 9–18 months. The vaccine was protective in 80.3% of all infants. There were no differences in the prevalence of a protective level of antibody or antibody titer among groups of infants according to storage strategy. Differences in antibody titer between certain groups of infants could be explained by different vaccination schedules. Where birth dose coverage will be improved, HepB vaccine can be taken OCC for up to one month without affecting its immunogenicity.

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