Protection From Hepatitis B and Response to a Booster Dose
35 Years After Primary Series Vaccination
TAKE-HOME MESSAGE
This study assessed the anti–hepatitis B surface antigen antibody (anti-HBS) levels in a cohort of 1578 Native Alaskan adults and children who had received three doses of a hepatitis B vaccine 35 years ago. Individuals with anti-HBS levels <10 mIU/mL received a booster and were evaluated 30 days later. In a group of 112 individuals who had responded to the original series of vaccines, 47.3% had anti-HBS levels ≥10 mIU/mL. Among individuals who were eligible for and received a booster, 73.7% had anti-HBS levels ≥10 mIU/mL at 30 days. No cases of hepatitis B were reported.
Among all participants, there was an estimated 86% protection rate 35 years after the original vaccination series. There is no immediate need for booster doses in the general population.
– Natasha von Roenn, MD
abstract
This abstract is available on the publisher's site.
BACKGROUND AND AIMS
The duration of protection from hepatitis B vaccination in children and adults is not known. In 1981, we used three doses of plasma-derived hepatitis B vaccine to immunize a cohort of 1578 Alaska Native adults and children from 15 Alaska communities who were ≥6 months old.
APPROACH AND RESULTS
We tested persons for antibody to hepatitis B surface antigen (anti-HBs) levels 35 years after receiving the primary series. Those with levels <10 mIU/ml received one booster dose of recombinant hepatitis B vaccine 2-4 weeks later and were then evaluated on the basis of anti-HBs measurements 30 days postbooster. Among the 320 recruited, 112 persons had not participated in the 22- or 30-year follow-up study (group 1), and 208 persons had participated but were not given an HBV booster dose (group 2). Among the 112 persons in group 1 who responded to the original primary series, 53 (47.3%) had an anti-HBs level ≥10 mIU/ml. Among group 1, 73.7% (28 of 38) of persons available for a booster dose responded to it with an anti-HBs level ≥10 mIU/ml at 30 days. Initial anti-HBs level after the primary series was correlated with higher anti-HBs levels at 35 years. Among 8 persons who tested positive for antibody to hepatitis B core antigen, none tested positive for HBsAg or HBV DNA.
CONCLUSIONS
Based on anti-HBs level ≥10 mIU/ml at 35 years and a 73.7% booster dose response, we estimate that 86% of participants had evidence of protection 35 years later. Booster doses are not needed in the general population at this time.