Boosters for hepatitis B vaccination? Need for an evidence-based policy

Hall, Andrew J.

doi:10.1002/hep.23674

Cited by 25 publications

(16 citation statements)

References 39 publications

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“…110,111 Vaccineinduced anti-HBs titres decline rapidly in the first year and more gradually afterwards. 81 Among young adults who respond to a primary vaccine series with anti-HBs concentrations of ‡10 mIU ⁄ mL, up to 50% have low or undetectable concentrations (reflecting anti-HBs loss) 10-15 years after vaccination.…”

Section: For How Long Do Anti-hbs Antibody Titres Remain Positive Aftmentioning

confidence: 99%

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Gisbert

Chaparro

Esteve

2011

Alimentary Pharmacology &Amp; Therapeutics

105

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Section: For How Long Do Anti-hbs Antibody Titres Remain Positive Aftmentioning

confidence: 99%

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Gisbert

Chaparro

Esteve

2011

Alimentary Pharmacology &Amp; Therapeutics

105

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“…Taking the results of the active immunization studies into consideration, an anti‐HBs level of ≥10 mIU/mL implies the establishment of specific immunity against HBV, but does not always guarantee protection from HBV infection. In other words, an anti‐HBs level of ≥10 mIU/mL can protect against “disease,” but not protect against “infection.” Furthermore, the protective level of anti‐HBs is not an all‐or‐nothing phenomenon, and the frequency of infection seems to have a negative correlation with the level of anti‐HBs …”

Section: Why Is the Anti‐hbs Level Of ≥10 Miu/ml Considered Protective?mentioning

confidence: 99%

Discordance of hepatitis B vaccination policies for healthcare workers between the USA, the UK, and Germany

Komatsu

Klenerman

Thimme

2020

Hepatology Research

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The hepatitis B (HB) vaccine is effective for the prevention of HB virus infection. It has been widely accepted that an anti‐HB surface antibody (HBs) level ≥10 mIU/mL is protective against HB virus infection. Although transient infection can occur in individuals who attain a peak level of anti‐HBs ≥10 mIU/mL after primary vaccination, long‐term follow‐up studies show that successful primary vaccination can prevent individuals from acute clinical hepatitis and chronic infection. Healthcare workers (HCWs) are at‐risk individuals. Based on the accumulated data, the USA considers an anti‐HBs level ≥10 mIU/mL to constitute successful vaccination for HCWs. In contrast, because some anti‐HBs assays cannot accurately measure in the low anti‐HBs range, including 10 mIU/mL, the UK and Germany consider an anti‐HBs level ≥100 mIU/mL to constitute successful vaccination for HCWs. In the USA and UK, a booster dose is unnecessary for HCWs after successful vaccination. In Germany, anti‐HBs testing is recommended for HCWs who are at particularly high individual exposure risk 10 years after successful primary immunization, and a booster dose is offered if the anti‐HBs level has declined to ˂100 mIU/mL. The differences in the goal of HB vaccination, reliability of anti‐HBs assays, and use of booster vaccination cause discordance in HB vaccination policies for HCWs.

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“…More compelling evidence on the critical endpoint, protection against breakthrough infection with severe outcomes, should be acquired. 24 …”

Section: Postulated Premise For Booster Vaccination Against Hepatitismentioning

confidence: 99%

Revaccination against hepatitis B in late teenagers who received vaccination during infancy: Yes or no?

Zhou

2017

Human Vaccines & Immunotherapeutics

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The significance of vaccination against hepatitis B during infancy is recognized worldwide, however, whether booster or revaccination after a period of time following the primary vaccination is required remains controversial. Recently, cross-sectional epidemiological surveys found that HBsAg prevalence in subjects born after the implementation of mass vaccination was increased with age, which was attributed to waning of anti-HBs over time. However, comprehensive analysis of the closely related cross-sectional surveys showed that the age-specific increased HBsAg prevalence was more likely associated with the carry-over of the infection occurred in early life, likely due to imperfect coverage of hepatitis B vaccination at the beginning of its introduction. Latest studies showed that booster response could be observed in the majority of individuals vaccinated 30 years ago. Moreover, confirmed breakthrough HBV infection with severe consequences in successfully vaccinated individuals is extremely rare. Thus far no compelling evidence has been acquired to support booster vaccination in adolescence. The uncertainty regarding the duration of protection of hepatitis B vaccination, especially beyond 30 years after the primary vaccination, merits a systematically designed study to follow the same cohort of participants longitudinally, which differs from the cross-sectional studies reported previously, can hopefully offer more direct evidence to help us to determine whether revaccination of hepatitis B vaccine is necessary.

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Boosters for hepatitis B vaccination? Need for an evidence-based policy

Cited by 25 publications

References 39 publications

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Review article: prevention and management of hepatitis B and C infection in patients with inflammatory bowel disease

Discordance of hepatitis B vaccination policies for healthcare workers between the USA, the UK, and Germany

Revaccination against hepatitis B in late teenagers who received vaccination during infancy: Yes or no?

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