The first combined vaccine against hepatitis A and B: an overview

Thoelen, S; Damme, Pierre Van; Leentvaar-Kuypers, A.; Leroux‐Roels, Geert; Bruguera, Miguel; Frei, P.C.; Bakasenas, V.; Safary, Assad

doi:10.1016/s0264-410x(98)00421-6

Cited by 116 publications

(59 citation statements)

References 26 publications

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“…Seroprotection against HAV was fairly well detectable 32 and 48 months after administration of the last vaccine dose in the case and the control groups, respectively, with anti-HAV levels clearly above the threshold level of 20 mIU/ml in all vaccinees. These results are in accordance with previous studies reporting that protective levels of anti-HAV are maintained in all responder subjects 48 months after completion of vaccination course [15].…”

Section: Discussionsupporting

confidence: 93%

Primary Hepatitis A vaccination failure is a rare although possible event: results of a retrospective study

Bonanni

Bechini

Pesavento

et al. 2006

Vaccine

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A retrospective study was performed to evaluate whether the failure was primary or could be attributed to a specific lot of vaccine or to its inadequate handling and/or storage. Two distinct populations of vaccinees were selected in a 1:2 proportion. The case group (N = 31) included subjects who were vaccinated in the same period and with the same lot and batch of vaccine as the case. The control group (N = 62) included subjects who received different lot and batch of the same vaccine as the case group. A persisting antibody response to HAV vaccine was found among all subjects (anti-HAV >20 mIU/ml). The overall anti-HBs seropositivity rate (anti-HBs >10 mIU/ml) was 74%, without significant difference between the case (77%) and the control group (73%; P > 0.05). The reported Hepatitis A case can be attributed to a rare primary vaccine failure rather than to inefficacy of a specific lot of vaccine or to inappropriate vaccine handling or storage. Our study supports the indications for use of combined Hepatitis A + B immunization in travellers at risk for both infections, but stresses the need for information on correct hygienic behaviours while abroad.

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Section: Discussionsupporting

confidence: 93%

Primary Hepatitis A vaccination failure is a rare although possible event: results of a retrospective study

Bonanni

Bechini

Pesavento

et al. 2006

Vaccine

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“…7,8,11,12 Thus the unexpectedly low protection rate in the above-mentioned pilot study in a single medical practice cannot be confirmed. The reason for the low protection rates found in that particular study unfortunately cannot be clarified.…”

Section: Discussionmentioning

confidence: 86%

“…6 Previous studies on hepatitis A and hepatitis B vaccination, although seldom carried out on elderly people, mostly showed a HAV protection rate of about 98% and a HBV protection rate of about 95%. [7][8][9][10][11] Often combined HAV/HBV vaccines were slightly more effective than their monovalent counterparts. 7,8,10,12 Besides other factors 13 an effect of age on the success of vaccination against hepatitis B has long been suspected, 14,15 whereas the effect of age on HAV seroprotection rates is not well documented.…”

mentioning

confidence: 99%

Comparative evaluation of the immunogenicity of combined hepatitis A and B vaccine by a prospective and retrospective trial

Wolters¹,

Müller²,

Ross³

et al. 2009

Human Vaccines

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age are susceptible to infection and disease. [1][2][3] Complications of HAV infection occur more frequently in older persons 4 and case fatalities of up to 12.8% have been reported. 5 Hepatitis B is one of the most important vaccine-preventable illnesses and hence WHO has recommended in the early 1990s the incorporation of vaccination against the hepatitis B virus (HBV) into national immunization programs for children. 6 Previous studies on hepatitis A and hepatitis B vaccination, although seldom carried out on elderly people, mostly showed a HAV protection rate of about 98% and a HBV protection rate of about 95%. [7][8][9][10][11] Often combined HAV/HBV vaccines were slightly more effective than their monovalent counterparts. 7,8,10,12 Besides other factors 13 an effect of age on the success of vaccination against hepatitis B has long been suspected, 14,15 whereas the effect of age on HAV seroprotection rates is not well documented.In a previous publication, we reported a failure of combined vaccination against hepatitis A and B in a cohort of more than 100 elderly individuals from a single medical practice that was enrolled in a retrospective survey. After completion of three doses of Twinrix ® under so-called every day conditions the subjects were recalled to give a fresh serum sample 1-36 month (average 16.8) and only 35% of all individuals developed antibodies against both viruses. Furthermore, only 29% and 65% of the vaccinees older than 40 years were protected against HBV and HAV infection, respectively. 16 However, the results of this investigation have been controversially discussed. The retrospective study design, as well as the fact that the period between the completion of vaccination and the antibody testing was exceptionally long, were aspects which have been criticized in particular. 17 After inspection by the German regulatory authority, no reason was found to explain the low seroprotection rate. In cooperation with the European regulatory authority they requested further investigation to prove the potential of the vaccine.To meet all these criticisms, we have conceived a multicenter study consisting of both a prospective and a retrospective cohort in order to re-examine the success of the combined hepatitis A and hepatitis B vaccine Twinrix ® in general and to re-evaluate in particular the potential impact of age of the subjects that might cause lower HAV and HBV seroprotection rates.In the past, immunogenicity of hepatitis A and B vaccines needed to be questioned in persons of advanced age, especially in those of 40 years and older.We performed a comparative multicenter prospective and retrospective study with the combined hepatitis A and B vaccine Twinrix ® to identify factors influencing the results of the vaccination in a population of all age groups.Out of 489 subjects enrolled, 241 were vaccinated in a prospective study (group 1) and 248 subjects in a retrospective study (group 2) in 17 German centers with median age of 40.1 (14-79) years.Following three applications of the combined hepat...

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“…4 The combined hepatitis A and B vaccine can be given from 1 year of age onwards, in three doses, at 0, 1 and 6 to 12 months. 19,20 The adult presentation of this combined vaccine can be administered to children aged 1 to 15 years, in two doses (0 and 6 to 12 months). 21,22 Live oral poliomyelitis vaccine (OPV) and inactivated poliomyelitis vaccine (IPV)…”

Section: -Valent Conjugate Andmentioning

confidence: 99%