Hep B vaccine does not increase risk of chronic lung disease in preterm babies, finds study

Preterm babies who receive a hepatitis B virus (HBV) vaccine at birth aren’t at increased risk of developing a chronic lung disease that affects newborns, according to a new study.

The research, led by Murdoch Children’s Research Institute (MCRI) and published in the Bulletin of the World Health Organization (WHO), found that babies born before 29 weeks gestation who had a HBV vaccine shortly after birth weren’t more likely to be diagnosed with bronchopulmonary dysplasia (BPD) than unvaccinated babies.

For the study, the largest of its kind in the world and involving 818 preterm babies in Victoria, used the Vaccine Safety Health Link. The link joins together multiple state-wide immunization and health outcome datasets. It found that 51 percent of the vaccinated babies went onto develop BPD, compared to 62 percent in the unvaccinated group.

BPD is a severe lung disease that is common among very preterm babies and can cause a range of health and developmental challenges including asthma, heart problems and neurodevelopmental disability.

HBV, the most common blood-borne virus in Australia, attacks the liver and can be passed on in utero. Babies that are infected are 90 percent more likely to develop chronic infection compared with those infected later in infancy or childhood. The most effective preventive intervention for HBV is vaccination.

The WHO and Australian guidelines recommend that all children receive a birth dose HBV vaccine, no matter their size. However, the rates of vaccination for HBV among preterm babies varies across Australia and globally.

MCRI researcher Hannah Morgan said the study supported the existing recommendations to immunize all newborns against hepatitis B within 24 hours of birth.

“This study identified no evidence of an increased risk of BPD in preterm infants who received the HBV vaccine compared to those who didn’t,” she said. These findings could help streamline decision-making in neonatal care units across the country.”

The initial concerns about a potential link were raised by Australian researchers who observed an association between specific antibodies after vaccination and a higher risk of BPD developing.

Ms Morgan said, given the recommendation to vaccinate, it was a national priority to investigate this further, especially in Victoria, which had the data to draw on.

“Victoria is unique in that we can link anonymous, statewide data on vaccination with birth records, perinatal and the outcomes of babies, ensuring the latest safety information can be provided,” she said.

“The Vaccine Safety Health Link, established by the Center for Health Analytics, has proven to be a powerful tool that continues to help us answer ongoing questions in vaccine research.”

Together with the Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC), the datasets provide public health recommendations to inform the Victorian Immunization Program.