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Hepatitis B vaccination at three months of age: a successful strategy?
Federica Chiara1, Giovanni Battista Bartolucci, Michele Mongillo
1Department of Molecular Medicine, University of Padova, Italy.
Insights
Infants vaccinated for hepatitis B virus (HBV) before three months had lower antibody levels in adulthood. Vaccination after the first year of life provided better long-term protection against HBV infection.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Hepatitis B virus (HBV) vaccination is mandatory for infants, children, and adolescents in Italy.
- Assessing long-term protective antibody levels in vaccinated individuals is crucial due to increasing HBV infection risks in adulthood.
Purpose of the Study:
- To evaluate the long-term efficacy of hepatitis B virus (HBV) vaccination based on the age at vaccination.
- To compare antibody levels and protection rates in adults vaccinated at different infant ages.
Main Methods:
- Two groups of medical students vaccinated at different ages were studied.
- Hepatitis B virus (HBV) antibodies and antigens were measured over an 18-year follow-up period.
Main Results:
- Students vaccinated after one year of age had significantly higher protective antibody levels (83.0%) compared to those vaccinated at three months (52.8%).
- A higher rate of non-protective antibodies was observed in individuals vaccinated earlier in infancy.
- Immunological memory remained robust, with 97.8% achieving protective antibody levels after a booster dose.
Conclusions:
- Vaccination against hepatitis B virus (HBV) after the first year of life confers superior long-term protection.
- While early infant vaccination shows lower antibody persistence, robust immunological memory is maintained, indicating effective protection after booster doses.
Abstract:
Vaccination of infants, children and adolescents against the hepatitis B virus (HBV) is mandatory in Italy. It is crucial to assess whether vaccinated subjects have protective antibody level during adulthood when the risk of HBV infection increases due to lifestyle or occupational exposure. Two groups of students attending to University of Padova Medical School were enrolled between 2004 and 2011 and HBV antibodies and antigens were measured. The first group (Group A) comprised students vaccinated at three months of age and the second group (Group B) comprised students vaccinated after the first year of life. The follow-up was 18.0 (Group A) and 17.9 (Group B) years. The students vaccinated at three months of age had a higher rate of non-protective antibodies (47.2%) comparing to those vaccinated after the first year of life (17.0%, P<0.0001) with a significantly lower antibody level (P<0.001). The rate of non-protective antibodies was inversely related to vaccination age. The results clearly show that children vaccinated after the first year of life are better protected against HBV. On the other hand, both groups show a good immunological memory as evidenced by the achievement of protective antibody level after the booster dose in 97.8% of subjects.
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