Response to supplementary vaccination with recombinant or plasma hepatitis B vaccine in healthy non-responding children
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K F Cheng1, M H Chang, C Y Lee
1Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China.
Insights
Recombinant hepatitis B (HB) vaccine effectively induced immune responses in children who previously did not respond to plasma-derived HB vaccine. This suggests they may be hyporesponders, not non-responders.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Hepatitis B (HB) vaccine non-response is a clinical challenge.
- Plasma-derived HB vaccines have shown variable efficacy in some populations.
- Assessing alternative vaccine strategies is crucial for improving HB immunity.
Purpose of the Study:
- To evaluate the efficacy of recombinant HB vaccine in children who failed to respond to plasma-derived HB vaccine.
- To compare the immunogenicity of recombinant versus plasma-derived HB vaccines in non-responders.
- To investigate the potential for hyporesponsiveness in non-responding children.
Main Methods:
- Fifty-three non-responding children received either three doses of recombinant HB vaccine (Group A) or two additional doses of plasma HB vaccine (Group B).
- Anti-HBs titres were measured to assess seroconversion and immune response.
- Geometric mean titres (GMT) and seroconversion rates were compared between groups.
Main Results:
- Group A (recombinant vaccine) achieved 100% seroconversion after three doses, with 50% achieving high anti-HBs titres (>1000 IU l-1).
- Group B (plasma vaccine) showed a 61.9% response rate after two additional doses.
- Group A demonstrated a significantly higher GMT (104.7 IU l-1) and seroconversion rate (87.5%) compared to Group B (75.9 IU l-1 and 61.9%) after two doses.
Conclusions:
- Three doses of recombinant HB vaccine are highly effective in inducing immune responses in children previously unresponsive to plasma-derived HB vaccine.
- The findings suggest that children who fail to respond to plasma-derived HB vaccine may be hyporesponders rather than true non-responders.
- Recombinant HB vaccine represents a promising strategy for overcoming non-responsiveness to hepatitis B vaccination.
Abstract:
Fifty-three children who failed to respond to four doses of plasma hepatitis B (HB) vaccine (anti-HBs titre < 10 IU l-1) were divided into two groups and received revaccination with either three doses of recombinant HB vaccine (10 micrograms/dose, by 0, 1, 6 month schedule; group A) or two additional doses of plasma HB vaccine (5 micrograms/dose, by 0, 1 month schedule; group B) respectively. Thirty-two vaccinees in group A had a response rate (with anti-HBs > 10 IU l-1) of 53.1% (17/32), 87.5% (28/32), and 100% (32/32) after first, second and third doses of the vaccine respectively. Twenty-one vaccinees in group B had a response rate of 61.9% (13/21) after two additional doses of plasma vaccine. High anti-HBs titres (> 1000 IU l-1) were noted in 50% of the vaccinees in group A after three doses of vaccine. Comparing anti-HBs response between group A and group B after two additional doses of HB vaccine, group A had a higher anti-HBs titre (geometric mean titre 104.7 IU l-1 versus 75.9 IU l-1) along with a better seroconversion rate (87.5 versus 61.9%). However, the differences in vaccine dose between the two groups may also be a contributory factor. Our findings indicate that three doses of recombinant HB vaccine were invariably effective in eliciting a good immune response in previous non-responders to the four doses of plasma HB vaccine. Therefore, it is speculated that these young vaccinees who did not respond to four doses of plasma HB vaccine may not be real non-responders, but hyporesponders.