Fan and colleagues conducted a study to quantitatively evaluate the immune response to hepatitis B vaccine in preterm or low birth weight infants.

A literature search was conducted in 4 databases without any date restrictions in December 2018. The pooled ORs, mean differences, and their corresponding 95% CIs were calculated with random-effects models using the DerSimonian-Laird estimator. The potential risk of bias of each study was determined with the help of the Newcastle-Ottawa Scale. The stability and publication bias of the pooled estimates were also assessed. Analyses were completed in 2019.

Twenty seven studies involving 22,202 infants were included in the analysis. Preterm infants were found to have significantly poorer immune responses to the hepatitis B vaccine. Preterm infants had 1.36 times higher likelihood of exhibiting nonresponse to the hepatitis B vaccine (95% CI=1.12, 1.65, p=0.002) compared to full-term infants. Pooled estimates for preterm birth may be subject to a potential publication bias. However, the leave-one-out analysis and fail-safe number indicated that these results were stable. The association between low birth weight and impaired immune response to the hepatitis B vaccine was not found to be statistically significant when birth weight was segregated at 2,500 g.

The results point to an association between preterm birth and decreased immune responses to hepatitis B vaccine.

 Source: Fan W, Zhang M, Zhu Y-M, Zheng Y-J. Immunogenicity of Hepatitis B Vaccine in Preterm or Low Birth Weight Infants: A Meta-Analysis. Am J Prev Med. 2020 Jun 18;S0749-3797(20)30150-1.