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Efficacy of hepatitis B vaccination in children with rheumatic diseases

Toaki Kohagura1, Shinji Kawabe1, Naoki Abe1

  • 1Department of Infection and Immunology, Aichi Children's Health and Medical Center, Aichi, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|November 4, 2020
PubMed

Insights

Hepatitis B (HB) vaccination efficacy in children with rheumatic diseases is limited, especially with mycophenolate mofetil (MMF). Secondary vaccine series may be needed for these immunocompromised pediatric patients to achieve protection.

Area of Science:

  • Pediatric Rheumatology
  • Immunology
  • Vaccinology

Background:

  • Hepatitis B (HB) vaccination is crucial for immunocompromised children.
  • Limited data exists on HB vaccine efficacy in pediatric rheumatic disease patients on immunosuppressants.

Purpose of the Study:

  • To evaluate the efficacy of HB vaccination in children with rheumatic diseases receiving immunosuppressive therapy.
  • To identify factors affecting seroconversion rates after HB vaccination.

Main Methods:

  • Retrospective analysis of pediatric patients with rheumatic diseases receiving HB vaccination during immunosuppressive treatment.
  • Assessed seropositivity after primary and secondary vaccination series.
  • Evaluated associations between specific immunosuppressants and seroconversion.

Main Results:

  • 58% of patients achieved seropositivity after the primary HB vaccine series.
  • Mycophenolate mofetil (MMF) was associated with significantly lower seroconversion rates (27%) compared to methotrexate (80%).
  • A secondary vaccine series increased seropositivity to 86% in non-responders.

Conclusions:

  • MMF significantly impedes seroconversion following primary HB vaccination in pediatric rheumatic disease patients.
  • Secondary HB vaccination series are recommended for these patients to ensure adequate immune protection.
  • Further research into optimal vaccination strategies for immunocompromised pediatric populations is warranted.
Abstract

Keywords:
childrenhepatitis B virusimmunosuppressive therapyrheumatic diseasevaccination

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