Adolescent hepatitis B vaccination. A review

Adolescents and young adults are at particular risk for HBV. Many countries with varying degrees of incidence now incorporate late childhood and/or adolescent HBV immunizations into their vaccine schedules. Available vaccines are highly effective in inducing long-term seroprotection and are considered of equivalent immunogenicity for most purposes. Immunologic memory maintains seroprotection in the absence of measurable HBsAb. Recent innovations have included the 2-dose, 10 mg Recombivax HB regimen for those 11-15 years old and Twinrix, a combination hepatitis A and B vaccine. The immunocompromised are at increased risk for hypo or non-response to HBV vaccine and loss of immunologic memory. These patients should have post vaccination testing for HBsAb titers as well as periodic testing thereafter. If their HBsAb titer decreases to less than 10 mIU/ml, they should receive a booster dose.