Reduced protective efficacy of hepatitis B vaccine among fully vaccinated children in Ethiopia
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Updated: Jul 24, 2025
Analysis of HBV-Specific CD4 T-cell Responses and Identification of HLA-DR-Restricted CD4 T-Cell Epitopes Based on a Peptide Matrix
Published on: October 20, 2021
Adane Adugna1, Gebereselassie Demeke1, Milkiyas Toru1
1Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Insights
Hepatitis B vaccination showed intermediate protective efficacy in children, with some vaccinated individuals still infected with the hepatitis B virus (HBV). This suggests a need to reassess vaccine effectiveness in the study region.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Hepatology
Background:
- Hepatitis B vaccination is a standard public health measure recommended for all children.
- Ensuring vaccine efficacy is crucial for controlling the spread of hepatitis B virus (HBV).
Purpose of the Study:
- To evaluate the protective efficacy of the hepatitis B vaccine in children.
- To determine the sero-prevalence of hepatitis B virus infection among vaccinated children.
Main Methods:
- A community-based cross-sectional study involved 165 fully vaccinated children aged 5-12 years.
- Serum samples were analyzed for hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (anti-HBc), and anti-hepatitis B surface antibody (anti-HBs) titers using ELISA.
- Statistical analysis included multivariate logistic regression to identify risk factors.
Main Results:
- The sero-prevalence of HBsAg and anti-HBc was 4.2% and 4.8%, respectively.
- 78.2% of vaccinated children achieved protective anti-HBs titers (≥ 10 mIU/ml), with 58.9% classified as hypo-responders.
- Children aged 5-7 years, those born to HBV-positive mothers, and those with a history of injectable medications or hospital admission showed higher likelihoods of HBV infection markers.
Conclusions:
- An intermediate prevalence of childhood HBV infection was observed despite vaccination.
- The findings suggest potentially low protective efficacy of the hepatitis B vaccine in the studied area.
- Further investigation into vaccine response and risk factors for HBV infection in vaccinated children is warranted.
Background:
Hepatitis B vaccination is recommended for all children at birth within 24 hours or during childhood.
Objective:
This study was aimed to evaluate protective efficacy of hepatitis B vaccine and estimate the sero-prevalence of hepatitis B virus infection among vaccinated children.
Materials And Methods:
A community-based cross-sectional study was conducted from March, 2021 to October, 2021 in Debre Markos town. A simple random sampling technique was used to select 165 fully vaccinated children aged 5-12 years old. A serum sample was used to determine hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (anti-HBc), anti-hepatitis B surface antibody titer (anti-HBs) using ELISA.
Results:
The seroprevalence of HBsAg and anti-HBc anti-body was found to be 4.2% and 4.8% respectively. Of 165 fully vaccinated children, 129 (78.2%) had anti-HBs titer ≥ 10 mIU/ml. Among 129 sero-protected children, 76 (58.9%) were hypo-responders whereas the rest 53 (41.1%) were good responders. Those children within the age group of 5-7 years were 2.9 times (AOR: 2.873, 95% CI: 1.156, 7.141) (P<0.023) more likely to respond to HBV vaccine. Multivariate logistic regression revealed that children who were born from HBV positive mothers (AOR 3.917, 95% CI: 1.456, 5.365, P<0.027) and those who had history of injectable medications (AOR 9.232, 95% CI: 1.503, 11.697, P<0.016) were more likely to be HBsAg positive. Children who had history of hospital admission (AOR 6.973, 95% CI: 1.495, 8.530, P<0.013) were more likely to be anti-HBcAb positive.
Conclusions:
There was an intermediate prevalence of childhood HBV infection despite being vaccinated suggesting low protective efficacy of hepatitis B vaccine in the study area.
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