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Hepatitis B vaccination in high-risk infants: 10-year follow-up
J S Wu1, L Y Hwang, K J Goodman
1University of Texas-Houston, School of Public Health, Baylor College of Medicine, USA.
Insights
Hepatitis B vaccination in high-risk infants shows high antibody persistence up to 10 years. Booster shots appear unnecessary due to sustained immunity and low infection rates, indicating long-term vaccine efficacy.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Hepatitis B remains a significant global health concern, particularly for infants born to infected mothers.
- Long-term vaccine efficacy studies are crucial for optimizing vaccination schedules and public health strategies.
Purpose of the Study:
- To evaluate the long-term efficacy of hepatitis B vaccination in high-risk infants.
- To determine the persistence of antibodies and the incidence of hepatitis B virus (HBV) infection up to 10 years post-vaccination.
Main Methods:
- A cohort of 805 infants vaccinated at birth in Taiwan (1981-1984) was followed to age 10.
- Life table survival and Cox multivariate analyses were employed to assess vaccine response and infection rates.
- Antibody titers, maternal factors, and demographic data were analyzed as predictors of vaccine efficacy.
Main Results:
- At 10 years, 85% of vaccine responders maintained antibodies to hepatitis B surface antigen (anti-HBs).
- The cumulative incidence of HBV infection was 15%, with only three children becoming carriers.
- Higher initial anti-HBs titers at 12 months strongly predicted sustained antibody levels and reduced HBV infection risk.
Conclusions:
- Hepatitis B vaccination demonstrates durable efficacy in high-risk infants, with sustained antibody persistence.
- Booster revaccination within 10 years appears unnecessary given the high antibody levels and low infection rates observed.
- Maternal hepatitis B e antigen positivity is a significant factor influencing long-term antibody persistence.
Abstract:
The long-term efficacy of hepatitis B vaccination among high-risk infants was determined in 805 vaccine responders, immunized at birth in Taiwan during 1981-1984 and followed to age 10 years, via life table survival and Cox multivariate analyses. At 10 years, cumulative persistence of antibody to hepatitis B surface antigen (anti-HBs) was 85%, and cumulative incidence of hepatitis B virus (HBV) infection was 15%. Three children became carriers. Twelve-month anti-HBs titer was the strongest predictor of efficacy. The higher the initial titer, the lower the risk of anti-HBs loss (relative risk [RR], 0.26 for titer of 100-999 mIU/mL; RR, 0.08 for titer >1000 mIU/mL; P<.001) and HBV infection (RR, 0.55 and 0.27; P<.05). Maternal hepatitis B e antigen positivity but not hepatitis B immunoglobulin dose or gender predicted greater antibody persistence to age 10 years. Because the level of antibody persistence remained high and few became carriers, booster revaccination within 10 years seems unnecessary.