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Participants with a suboptimal response to all four serogroups at a post-vaccination timepoint received an additional vaccine dose and were excluded from the study.
In the original study, children who did not seroconvert after 2 doses were offered an additional vaccine dose.
However, in low-income countries there may be no extra budget available to administer the additional vaccine dose even if it would be cost-effective.
The anamnestic effect of anti-HBs antibody was observed in individuals who received an additional vaccine dose, who showed a rapid and immediate rise in antibody titre.
Studies were not excluded when subjects received additional vaccine dose(s) because they did not achieve seroprotective concentrations or when inclusion of a fraction of subjects meeting an exclusion criterion was deemed unlikely to affect the findings.
Participants with a suboptimal response to one of the four serogroups were not excluded from the study, unless the study investigator considered that the epidemiological risks warranted the administration of an additional vaccine dose.
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Administration of additional vaccine doses for nonresponders is not associated with an increase in adverse events (16).
Bats should only be handled by vaccinated and trained people, however, even in this group, a bite or scratch warrants additional vaccine doses [ 18, 21].
This led to an increase in participation among young people and a demand for additional vaccine doses in 2013 during the subsequent phase of introduction.
Administration of schedules using an extended interval to the final dose, four vs. three doses, or additional vaccine doses may achieve seroprotection in a greater proportion of adults with diabetes, including those who do not respond to an initial series.
However, for infants born to HBsAg women, passive and active immunoprophylaxis is provided at birth and two additional vaccine doses at the ages of 1-2 months and 6-18 months respectively.
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