Persistence of long-term immunity to hepatitis B among adolescents immunized at birth

Area of Science:

• Immunology
• Vaccinology
• Public Health

Background:

• The duration of immunity following recombinant hepatitis B vaccination initiated at birth is not fully understood.
• Waning immunity may increase young adults' risk of hepatitis B virus infection from occupational or behavioral exposures.

Purpose of the Study:

• To assess the long-term persistence of protection conferred by a recombinant hepatitis B vaccine regimen (5 mcg, 2.5 mcg, 2.5 mcg) administered starting at birth.
• To evaluate the anamnestic response to a booster dose at 10 and 15 years post-vaccination as a measure of immune memory.

Main Methods:

• A cohort of children vaccinated from birth with a 3-dose recombinant hepatitis B vaccine was followed.
• Participants received a booster dose 10 and 15 years after primary vaccination.
• Anamnestic response to the booster dose was measured to assess immune memory persistence.

Main Results:

• Over 70% of participants who lost protective antibody levels demonstrated an anamnestic response to the booster dose.
• Response rates to the booster remained stable between the 10 and 15-year follow-up points.
• A high initial antibody concentration post-primary vaccination correlated with a sustained anamnestic response; however, 20-30% failed to mount an immune response after boosting.

Conclusions:

• Recombinant hepatitis B vaccination initiated at birth generally provides durable protection, evidenced by robust anamnestic responses 15 years later.
• Hepatitis B revaccination may be necessary for individuals vaccinated from birth if they face ongoing exposure risks.
• Future recommendations should consider studies evaluating protection against clinically significant hepatitis B disease.