Ethnic differences in immune responses to hepatitis B vaccine

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.