Waning immunity to plasma-derived hepatitis B vaccine and the need for boosters 15 years after neonatal vaccination

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Hepatology. 2004 Dec;40(6):1415-20.

Waning immunity to plasma-derived hepatitis B vaccine and the need for

boosters 15 years after neonatal vaccination.

Lu CY, Chiang BL, Chi WK, Chang MH, Ni YH, Hsu HM, Twu SJ, Su IJ, Huang LM,

Lee CY.

Department of Pediatrics, National Taiwan University Hospital, Taipei,

Taiwan.

Neonatal immunization with hepatitis B (HB) vaccine is highly effective;

however, more needs to be learned about the duration of protection and

indications for boosters. We measured antibody to HB core antigen

(anti-HBc), HB surface antigen (HBsAg), and pre- and postbooster titers of

HBsAg antibody (anti-HBs) 15 years after primary neonatal immunization with

plasma-derived HB vaccines in 2 cohorts of 15-year-old children. Group A

consisted of 78 children who were born to HB e antigen-positive HBsAg

carrier mothers and had developed protective levels of anti-HBs antibodies

(>/=10 mIU/mL) following HB immunization. Group B consisted of 113

apparently healthy children whose anti-HBs titers after vaccination were

unknown. Anti-HBs was undetectable (antibody titer <10 mIU/mL) in 29.9% in

group A and 62.4% in group B (P < .001). Anti-HBc was detected in 33.3 % in

group A and 4.4 % in group B (P < .001). After a single booster dose of HB

vaccine, 2.7% in group A and 3.3% in group B remained anti-HBs-negative. A

blunted serological response was noted in approximately 20% in both groups.

One HBsAg carrier was detected in group A (1.3%) and 4 in group B (3.5%).

Fifteen years after neonatal immunization with plasma-derived HB vaccine, a

large proportion of children exhibited waning immunity. This poses the risk

of breakthrough infection. A single booster augmented the serological

response to the vaccine in most but not all subjects. In conclusion, our

findings suggest that one or more booster immunizations are needed in

seronegative subjects by at least 15 years following neonatal immunization

with plasma-derived HB vaccine. (HEPATOLOGY 2004;40:1415-1420.).

PMID: 15565627 [PubMed - in process]