Persistence of Anti-Hbs after up to 30 Years in Health Care Workers Vaccinated against Hepatitis B Virus

Abstract

The burden of hepatitis B virus (HBV) infection is a serious public health problem all over the world. Vaccination remains the most effective prevention measure, and safe and effective HBV vaccines have been available since 1982. Health care workers (HCWs) vaccinated against HBV and prospectively followed up for at least 14 years were classified by their antibody titers after primary vaccination as: poor responders (10–99 mIU/mL); moderate responders (100–999 mIU/mL); and good responders (≥1000 mIU/mL). The incidence of antibody loss was calculated for 1000 person-years and the anti-HBs persistence was calculated. The analysis concerned 539 HCWs: 494 good responders (91.7%); 37 moderate responders (6.9%); and eight poor responders (1.5%). The incidence of anti-HBs loss was 52.1 per 1000 person-years for the poor responders, 11.3 per 1000 person-years for the moderate responders, and 1.4 per 1000 person-years for the good responders. The mean persistence of anti-HBs differed significantly between the three groups, being: 19.2 years (95% CI: 15.6–22.8), 25.4 years (95% CI: 23.0–27.9), and 31.0 years (95% CI: 30.5–31.5) for the poor, moderate and good responders, respectively. In conclusion, our findings demonstrate a good persistence of protective anti-HBs titers in HCWs exposed to occupational risk for up to 30 years after a primary vaccination cycle (even without a booster dose) if their titer was initially higher than 100 mIU/mL.

12 Months Persistent Immunogenicity after Hepatitis B Vaccination in Patients with Type 2 Diabetes and Immunogenicity of Revaccination in Non-Responders: An Open-Label Randomized Controlled Trial

“…The proportion of participants whose anti-HBs remained positive twelve months after being fully vaccinated increased with the increase of initial concentration one month after being fully vaccinated, which meant that higher anti-HBs concentrations are associated with longer protection duration. It was considered to be consistent with previous studies [31,36,37]. Moreover, this study suggests that subjects with a low anti-HBs concentration at the primary response should be carefully followed up.…”

Antibody levels and protection after Hepatitis B vaccine in adult vaccinated healthcare workers in northern Uganda

“…Although there is currently no screening to establish immune response to hepatitis B vaccine in Uganda, it is likely that despite the booster dose of the vaccine, vaccinated individuals already had sufficiently high levels of anti-HBs in the body. This could be due to the persistence of anti-hepatitis B antibodies in vaccinated individuals [22]. Our findings indicate that completion of all three hepatitis B vaccine doses is sufficient for the development of protective anti-HBs titers.…”

“…Our findings show that regular screening to assess extent of hepatitis B immune protection among individuals who have completed all the three hepatitis B vaccine dose schedules may not be necessary due to the limited resources in most LMICs. However, for the few individuals who had weak or no protective immune response (<10mIU/mL) against HBV following complete vaccination, provision of a challenge dose of the vaccine is recommended as this has previously been shown to prompt development of immunity [22].…”

Association between history of HBV vaccine response and anti-SARS-CoV-2 spike antibody response to the BioNTech/Pfizer’s BNT162b2 mRNA SARS-CoV-2 vaccine among healthcare workers in Japan: A prospective observational study

“…History of HBV vaccination and anti-HBs antibody titer results were obtained from employee health records recorded by the University’s occupational health program, which tests the HBV antibody titer levels of all its employees at the time of recruitment and follows their vaccination history and follow-up HBs antibody tests if they have no documented history of full vaccination. We defined HBV vaccine “non-responders” as those who had HBs antibody levels less than 10 mIU/mL after their HBV vaccination course and “weak responders” as those with titers between 10 mIU/mL and 100 mIU/mL [ 8 , 9 ]. Individuals with anti-HBs titers of 100 mIU/mL or greater were defined as “normal” responders.…”

“…Data from HBV vaccination studies show that roughly 5% of individuals are “non-responders” to HBV vaccination, meaning their immune systems do not elicit protective levels of humoral response (defined as HBs antibody titers of ≥10 mIU/mL) after receiving a full vaccination course [ 8 ]. Weak antibody response (HBs antibody titer between 10 and 100 mIU/mL) is also common, and both have been associated with older age, obesity, smoking, male gender, and immunosuppressed states [ 9 , 10 ]. The mechanism for non-response is unclear, but genetic predisposition, including certain HLA allele types, and immunosenescence are thought to play a key role [ 11 , 12 ].…”