Duration of protection against hepatitis A for the current two-dose vaccine compared to a three-dose vaccine schedule in children

Abstract

Background-Hepatitis A is mostly a self-limiting disease but causes substantial economic burden. Consequently, United States Advisory Committee for Immunization Practices recommends inactivated hepatitis A vaccination for all children beginning at age 1 year and for high risk adults. The hepatitis A vaccine is highly effective but the duration of protection is unknown.Methods-We examined the proportion of children with protective hepatitis A antibody levels (anti-HAV ≥20 mIU/mL) as well as the geometric mean concentration (GMC) of anti-HAV in a cross sectional convenience sample of individuals aged 12-24 years, who had been vaccinated with a two-dose schedule in childhood, with the initial dose at least 5 years ago. We compared a HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript subset of data from persons vaccinated with two-doses (720 EL.U.) at age 3-6 years with a demographically similar prospective cohort that received a three-dose (360 EL.U.) schedule and have been followed for 17 years.Results-No significant differences were observed when comparing GMC between the two cohorts at 10 (P = 0.467), 12 (P = 0.496), and 14 (P = 0.175) years post-immunization. For the three-dose cohort, protective antibody levels remain for 17 years and have leveled-off over the past 7 years. Conclusion-The two-and three-dose schedules provide similar protection >14 years after vaccination, indicating a booster dose is not needed at this time. Plateauing anti-HAV GMC levels suggest protective antibody levels may persist long-term.

Seroprevalência do Anticorpo do Vírus na Hepatite A em Viajantes Portugueses: Um Novo Paradigma

“…6 It is highly immunogenic conferring protection against HAV in approximately 95% of the vaccinated travelers. 7 Protection is considered to be lifelong after a complete hepatitis A vaccination schedule (two doses) 8,9 and a combined hepatitis A/B vaccine is also available in some countries. 10 Routine vaccination of children is an effective way to reduce hepatitis incidence in developed countries, however only some of them had implement it in the national immunization program as a mandatory vaccine or considered it for some risk groups.…”

Self-reported hepatitis A vaccination as a predictor of hepatitis A virus antibody protection in U.S. adults: National Health and Nutrition Examination Survey 2007–2012

“…A limitation of these analyses was waning of hepatitis B vaccine-induced antibody to levels no-longer defined as protective [28]. In contrast, after hepatitis A vaccination, anti-HAV has persisted in the majority of responders since vaccines were approved for use in 1995–1996; mathematical modeling suggests persistence of vaccine-induced anti-HAV might be ≥25 years in as many as 95% of the population [29–32]. …”

Reduced dose human papillomavirus vaccination: An update of the current state-of-the-art

“…The use of reduced dose schedules in vaccinology is not unusual as other vaccines such as Pneumococcal, Hepatitis A and Meningococcal C dosing schedules have been revised from three to two doses, following clinical studies that have demonstrated noninferiority in immunogenicity and safety [36][37][38]. High costs of HPV vaccines and logistical issues with delivery, together with higher antibody responses observed in young adolescents, has prompted the exploration of reduced dose HPV schedules.…”