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Early and long term anamnestic response to HBV booster dose among fully vaccinated Egyptian children during infancy
Iman I Salama1, Samia M Sami2, Zeinab N Said3
1Community Medicine Research Department, National Research Centre, Egypt.
Insights
Most children vaccinated against Hepatitis B virus (HBV) show a strong early response to a booster dose, even with low or undetectable antibodies. This indicates long-term immune memory, suggesting booster doses may not be necessary for healthy children.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Hepatitis B virus (HBV) vaccination is crucial for preventing infection.
- Assessing the durability of immune memory after infant vaccination is essential for public health strategies.
- Many children may lose seroprotective levels of anti-HBs antibodies over time.
Purpose of the Study:
- To evaluate the early and long-term anamnestic response to a booster dose of HBV vaccine in children who were not seroprotected.
- To identify risk factors associated with the absence of an anamnestic response to HBV vaccination.
- To determine the long-term efficacy of the HBV vaccination program in children with waning or undetectable antibody levels.
Main Methods:
- A national community-based study involving 3600 children aged 9 months to 16 years, fully vaccinated in infancy.
- Identified 1535 children with non-seroprotective anti-HBs levels (<10 IU/L) and no active infection.
- Administered a 10 μg booster dose of Euvax HBV vaccine to 1121 children and assessed anti-HBs levels at early (2-4 weeks) and long-term (1 year) intervals.
Main Results:
- 90.3% of children demonstrated an early anamnestic response after the booster dose.
- Children with undetectable pre-booster anti-HBs levels (<1 IU/L) had a significantly lower early response rate (85%) compared to those with detectable levels (90%).
- Absence of early response was predicted by undetectable anti-HBs, rural residence, and older age (15-16 years). After one year, 15% lost their response, predicted by poor early response and undetectable pre-booster anti-HBs.
Conclusions:
- Immunological memory for HBV vaccine persists even when anti-HBs antibody levels decline or become undetectable.
- The HBV vaccination program provides effective long-term protection, highlighting the robustness of immune memory.
- Booster doses may not be necessary for healthy children, as their immune system retains memory of the vaccine.
Objective:
To evaluate early and long term anamnestic response to a booster dose of HBV vaccine among non-seroprotected children.
Subjects And Method:
A national community based project was carried out on 3600 children aged 9 months to 16 years, fully vaccinated during infancy. They were recruited from 6 governorates representing Egypt. It revealed that 1535 children (42.8%) had non sero-protective anti-HBs (<10 IU/L) and were HBsAg or anti-HBc negative. A challenging dose of 10 μg of mono-valent Euvax HBV vaccine was given to 1121/1535 children. Quantitative assessment of anti-HBs was performed to detect early (2-4 weeks) and long term (one year) anamnestic responses.
Results:
Early anamnestic response developed among 967/1070 children (90.3%).Children having detectable anti-HBs (1-9 IU/L) significantly developed early anamnestic response (90%) compared to 85% with undetectable anti-HBs (<1 IU/L), P < 0.001. Multiple logistic analysis revealed that undetectable anti-HBs, living in rural residence and children aged 15-16 years were the most significant predicting risk factors for the absence of early anamnestic response (<10 IU/L), with AOR 2.7, 2.7 & 4.7 respectively. After one year, long term anamnestic response was absent among 15% of children who previously showed early response. Poor early anamnestic response and undetectable pre-booster anti-HBs were the significant predicting risk factors for absent long term anamnestic response, with AOR 18.7 & 2.7 respectively.
Conclusion:
Immunological memory for HBV vaccine outlasts the presence of anti- HBs and HBV vaccination program provides effective long term protection even in children showing waning or undetectable concentrations of anti-HBs. This signifies no need for a booster dose especially to healthy children.
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