A systematic review reveals that African children of 15–17 years demonstrate low hepatitis B vaccine seroprotection rates

Abstract

Childhood HBV immunization remains globally fundamental to the elimination of hepatitis B virus (HBV). However, monitoring proportions of HBV vaccine seroprotection and their determinants among African Pediatric recipients is crucial. This study sought to verify extent of immune protection accorded by the HBV vaccine in African children of up to 17 years of age by pooling the prevalence of seroprotection reported by primary studies conducted in the Northern, Western, and Southern African regions. We included 19 eligible articles out of the 197 initially downloaded, published from 1999 to 2021 from African Journals Online (AJOL), EMBASE, Scopus, and PubMed. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), University of York Centre for Reviews and Dissemination, under the registration number CRD42022361277. Significantly higher (p < 0.0001) proportion of HBV vaccine seroprotection (69.07%) was found among children under 15 years of age than children 15–17 years (32.368%), 95% CI [34.2454–39.0847%]. Whereas successful integration of the HBV vaccine on the extended programs on immunizations (EPI) has been a major achievement in the reduction of HBV infection in Africa, markedly reduced HBV vaccine seroprotection is persistently demonstrated among adolescent children 15–17 years of age. Future studies are required to clarify the need for booster dose vaccination in most at risk populations and age groups.

Hepatitis B virus infection, associated factors, knowledge and vaccination status among household contacts of hepatitis B index cases in Mwanza, Tanzania

“…Similar findings were observed in the study done in Iran which showed high vaccine coverage among children [23] . The observation of the majority of children especially those below 15 years being fully vaccinated is further supported by a recent systematic review from Africa that found a significantly higher proportion of HBV vaccine seroprotection among children under 15 years of age than children 15-17 years, linking this to successful implementation of the HBV vaccine on the extended programs on immunizations in Africa [11] .…”

“…Furthermore, even in low prevalence areas, certain populations such as drug abusers, men who have sex with men, and people living with HIV have high proportions of chronic HBV infection [10] . In addition, a recent systematic review has revealed that children between 15 and 17 years in Africa have lower hepatitis B vaccine seroprotection rate than children below 15 years [11] .…”

Long-Term Hepatitis B Vaccine Immunity in Ethiopian Children That Received a Pentavalent Vaccine Series: A Retrospective Cohort Study

“…Our study showed that adolescents aged 10 years and above were at significantly higher risk of lost seroprotection. Markedly low hepatitis B vaccine seroprotection among adolescents who completed their vaccinations during infancy was also witnessed in various other African countries according to a recently published systemic review [21]. Peak anti-HBs concentration achieved after primary vaccination and age-dependent decay in anti-HBs titers play key roles in protection against infection [16].…”