Characterization of an age-response relationship to GSK's recombinant hepatitis B vaccine in healthy adults: An integrated analysis

Abstract

The immune system becomes less effective with age, and older age is associated with an increased susceptibility to diseases and reduced responses to vaccination. Furthermore, some adult populations, such as those with diabetes mellitus, are at increased risk of acute hepatitis B virus (HBV) infection. Decreasing responses to vaccination with advanced age have been described, but it is not known at what age immunogenicity starts to reduce, or until what age immunogenicity remains acceptable (for example 80 % seroprotection post-vaccination). We characterized the relationship between age and seroprotection rate induced by recombinant HBV vaccination by conducting a pooled analysis of clinical trial data. Healthy adults aged 20 y who had been vaccinated with 20mg HBV vaccine (Engerix TM B, GSK Vaccines, Belgium) in a 0, 1, 6 months schedule in 11 studies since 1996 were included. The observed seroprotection rate, defined as an anti-HBV surface antigen antibody concentration 10 mIU/ml was 94.5% in the whole population (N D 2,620, Total vaccinated cohort), ranging from 98.6% in adults vaccinated at age 20-24 years, to 64.8% in those vaccinated at age 65 y A model on seroprotection rates showed a statistically significant decrease with age, and predicted that the anti-HBs seroprotection rate remains 90% up to 49 y of age and 80% up to 60 y of age. Individuals at risk of HBV infection should be vaccinated as early in life as possible to improve the likelihood of achieving seroprotection. Additional studies are needed to identify whether unvaccinated individuals older than 60 y would benefit from regimens that include additional or higher vaccine doses.

Possible Impact of 190G > A CCR2 and Δ32 CCR5 Mutations on Decrease of the HBV Vaccine Immunogenicity—A Preliminary Report

“…Decreasing responses to immunization with advanced age have been described previously [5,23]. A model on sero-protection rates presented by Van Der Meeren et al showed a statistically significant decrease in anti-HBs sero-protection rate with age, and predicted that it remains ≥80% up to 60 years of age [23]. This is in line with our results: 83% of patients from PCCs, with the mean age of 60 years, gained sero-protection after HBV vaccination.…”

The older traveller

“…It is important to note that age is the strongest predictor of vaccine response. In the study performed by Van Der Meeren et al [75], vaccine protection rate was above 90% in individuals aged 20-49 years and only 64.8% in those aged 65 years or more. Another study showed that only 75% of the people vaccinated after the age of 60 years develop protective antibody levels [77].…”

“…About 20% of patients with hepatitis B infection need to be hospitalised and the risk is doubled in individuals 50 years and older. What is more, elderly patients with co-morbidities, such as liver or renal disease or diabetes are at a higher risk of developing complications from hepatitis B [75]. However, the risk of chronic HBV infection in people over 40 years of age is lower in comparison to young adults (6% vs. 8%) [76].…”

A cross-sectional study on dental surgeons’ immune status against hepatitis B virus in the Public Health System

“…Nowadays, thanks to the evolution of genetic engineering, the immunization schedule comprises three doses, which must respect the administration interval between them (0, 30, 180 days), so that the immunization against the virus is guaranteed, with anti-HBs titers higher than 10 mIU/mL 2 . Concerning the vaccine coverage, a study conducted with participants in Australia, Belgium, Canada, Czech Republic, Germany, New Zealand, the Philippines, Russia, Spain, and the United States determined that the protective response occurs in 95% of children and adolescents, 90% of health young adults up to 49 years old, and ≥80% of individuals aged 60 years old or over 28 . In addition, according to WHO, immunosuppressed and hemodialised individuals have 50-70% of immunization against HBV, and individuals with liver disease have 60-70% 29 .…”