Long-term protection against hepatitis B after newborn vaccination: 20-year follow-up

Abstract

Our results show that combined active-passive immunization of newborns against hepatitis B provides persistent protection up to adolescence despite a frequent waning of anti-HBs antibodies, suggesting there is no need for booster vaccination during adolescence.

Immune persistence after hepatitis B vaccination in infancy – Fact or fancy?

“…In completed vaccinees, anti-HBc seroconversion has been found in 1.5% from 3-15 years of age 40 and in 8% 15 years later, 46 although none became chronic carriers. However, among complete vaccines in Taiwan, 1.3% were HBsAg positive at age 2-6 years, while the figure was 4.5% among incomplete vaccinees, 39 and 1.3% to 3.5% of the immunized infants became HBsAg carriers 15 years later.…”

“…In a study on 640 children born to HBsAg positive mothers and with completed vaccination, protective anti-HBs was 93% afterwards, then falling to 70%, 40% and 25% at 5, 10, and 15 years of age respectively. 40 Another study on 1095 subjects with early childhood vaccination and assessed at age 1-24 years found that while overall efficacy against infection and carriage were 83.4% and 96.5% respectively, population vaccine efficacy against infection decreased from 92.5% among 1-4 years old to 70.9% among 20-24 years old, and efficacy against carriage decreased from 100% to 91.1%. 41 When tested at specific ages, a significant waning in anti-HBs titer can be found at age 15 to 18 years.…”

“…47 Nevertheless, disappearance of an anamnestic effect has been shown in many studies. 10,40,41,45,48 One study found that following a booster dose in subjects who received 4 doses of vaccine during infancy, 28.7% had undetectable anti-HBs, while HBsAg-specific IFN-g-or IL-5-secreting peripheral blood mononuclear cells remaining negative in 27.2%, and it was estimated that 10.1% of the total population had lost their vaccine-conferred booster response. 49 .…”

Long-term persistence of immunity after hepatitis B vaccination: Is this substantiated by the literature?

“…In completed vaccinees, anti-HBc seroconversion has been found in 1.5% from 3-15 y of age 4 and in 8% 15 y later, 5 even though none of the subjects in these reports became chronic carriers at the time of the study. In Taiwan, 1.3% and 4.5% of complete and incomplete vaccinees respectively were HBsAg positive at age 2-6 y, 6 and 1.3% to 3.5% of immunized infants became HBsAg carriers 15 y later.…”

“…15 There is no dispute that following vaccination, antibody titer also falls with age, as shown in a study on 640 children with complete vaccination and born to HBsAg positive mothers that protective anti-HBs dropped from the initial 93% to 70%, 40% and finally 25% when tested at 5, 10, and 15 y of age respectively. 4 Another study also found that the percentage of protected individuals decreased with time with significant reduction of antiHBs GMT after 5 y to reach 10 mIU/mL in about 15 years' time. 16 The worst scenario was in Micronesians, as only 7.3% of uninfected individuals vaccinated at birth had antibody protection.…”