Ethnic differences in immune responses to hepatitis B vaccine
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Updated: Nov 5, 2026
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
1National Institute of Preventive Medicine, Department of Health, Taipei, Taiwan.
Insights
Hepatitis B vaccination in Taiwan showed lower antibody levels in aboriginal children compared to Han Chinese children. Host factors related to ethnic origin may explain this hyporesponsiveness to the hepatitis B vaccine.
Area of Science:
- Immunology
- Public Health
- Genetics
Background:
- Taiwan initiated a national hepatitis B virus (HBV) vaccination program for all newborns in 1986.
- Previous studies indicated varying immune responses to vaccines across different populations.
- Understanding vaccine hyporesponsiveness is crucial for optimizing public health strategies.
Purpose of the Study:
- To investigate serologic responses to the hepatitis B vaccine in aboriginal versus nonaboriginal children in Taiwan.
- To identify potential factors contributing to differences in antibody titers against hepatitis B surface antigen (anti-HBs).
- To explore the role of ethnic origin in HBV vaccine hyporesponsiveness.
Main Methods:
- A serologic survey was conducted in 1993 involving 1,812 fully vaccinated children from aboriginal and Han Chinese rural villages.
- Antibody titers against hepatitis B surface antigen (anti-HBs) were measured.
- Vaccine storage and transport (cold chain) integrity was evaluated; responses to other vaccines (Japanese encephalitis, diphtheria) were compared.
Main Results:
- Children in aboriginal villages exhibited significantly lower anti-HBs titers compared to children in nonaboriginal villages.
- Cold chain failures were ruled out as the primary cause for lower titers in remote aboriginal villages.
- Children with aboriginal parents had lower anti-HBs titers than those with Han Chinese parents; mixed-origin children showed intermediate titers.
Conclusions:
- Host factors related to ethnic origin appear to be responsible for HBV vaccine hyporesponsiveness in aboriginal populations.
- This hyporesponsiveness is specific to the HBV vaccine, as responses to other childhood vaccines did not show similar ethnic correlations.
- Further prospective studies are needed to confirm these findings and develop targeted strategies to improve vaccine efficacy in specific ethnic groups.
Abstract:
A national vaccination program against hepatitis B virus (HBV) to immunize every newborn was initiated in Taiwan in 1986. A serologic survey of 1,812 fully vaccinated children residing in four aboriginal villages and four adjacent nonaboriginal Han Chinese rural villages was conducted in 1993. Children in three of the four aboriginal villages had significantly lower titers of antibody against hepatitis B surface antigen (anti-HBs) than did children in the nonaboriginal villages. Evaluation of cold chain operation for vaccine storage and transport suggested that cold chain failure was not responsible for the fact that children residing in the more remote aboriginal villages had lower mean titers of anti-HBs. However, children whose parents were both aborigines had lower anti-HBs mean titer than did children whose parents were both ethnic Han Chinese. Children of mixed parental origins had intermediate mean titer of anti-HBs. Serologic responses to Japanese encephalitis virus and diphtheria vaccines did not show such correlation with ethnic groups, indicating that the determinant for HBV hyporesponsiveness among the aboriginal children is distinct from that of other childhood vaccines. It was therefore concluded that host factors pertaining to ethnic origin might be responsible for the hyporesponsiveness to HBV vaccine in the aboriginal populations. This finding, if substantiated with further prospective studies, might provide possible means for more targeted trials to improve vaccine response and to reduce vaccine failure among these well-defined ethnic groups.
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