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

Abstract

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.

Immune response to hepatitis B vaccination in pediatric patients with inflammatory bowel disease

“…In the Urganci et al study [12], the period after vaccination was 4 weeks, and the time was not reported in studies by Watts et al [10] and Moses et al [11]. It is documented that in immunocompetent individuals who are fully vaccinated against HBV, protective serologic titers may persist for more than 20 years, and no booster dose is recommended [15]. However, in immunosuppressed patients such as patients with IBD, the velocity of antibody weaning is unknown.…”

Long-term persistency of hepatitis B immunity: an observational cross-sectional study on medical students and resident doctors

“…Such evidence acquires significance in an occupationally exposed population at greater risk for HBV. As recently pointed out by the review of Zhao and Zhou [31], whether booster or revaccination after a period of time following the primary vaccination is required remains a debated issue. Nonetheless a booster response could be observed in most of subjects vaccinated 30 years ago, as confirmed by breakthrough HBV infection with severe consequences in successfully vaccinated individuals is extremely rare.…”

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

“…Although transient infection was infrequently documented, no new HBV carrier cases were identified in the 10‐year follow‐up study from Italy, the 20‐year follow‐up study from Thailand, and the 30‐year follow‐up study from Alaska . Two reviews of long‐term studies show that chronic HBV infection is an extremely rare event in successfully vaccinated individuals . These findings strongly suggest that a routine booster vaccine is not necessary if an adequate anti‐HBs level, ≥10 mIU/m, is achieved once.…”