How Long Does Hepatitis B Vaccination Last?

[Argirios Argiriou]

February 3, 2015

Abigail Zuger, MD reviewing Gara N et al. Clin Infect Dis 2015 Feb 15.

For healthy healthcare workers, boosters don't seem necessary.

Vaccine-induced immunity against hepatitis B virus (HBV) infection often wanes with time. Still, current guidelines do not recommend boosters for adults who are at ongoing risk for exposure (e.g., healthcare workers). Researchers correlated levels of antibody against hepatitis B surface antigen (anti-HBs) with time since receipt of HBV vaccination among 159 healthcare workers at the NIH who were vaccinated as adults. The group was divided about equally among those who had been vaccinated 10 to 15 years previously, 16 to 20 years previously, and >20 years previously.

The proportions of healthcare workers with protective anti-HBs levels were similar in the three groups (82%, 74%, and 76%, respectively). Both older participants and those who were older when they were vaccinated were more likely to lack protective antibody. Of the 36 participants (23%) with suboptimal antibody levels, 34 received single booster doses of vaccine; 3 weeks later, 32 booster recipients had antibody levels in the protective range.

Comment

The authors find these results encouraging, both for the durability of protective antibody titers in most of the healthcare workers studied and for the brisk anamnestic response induced by booster doses in the others, even decades after original vaccination. (In these individuals, exposure to actual virus would be expected to act as a de facto booster, eliciting protective antibody titers before viral infection could be established.) Thus, these data support current guidelines that HBV boosters are unnecessary in healthy vaccinated healthcare workers. Boosters are recommended for patients who are on dialysis or otherwise immunocompromised and who have documented suboptimal antibody levels.

Editor Disclosures at Time of Publication

Disclosures for Abigail Zuger, MD at time of publication Editorial boards New York Times; Clinical Infectious Diseases

Citation(s):

    Gara N et al. Durability of antibody response against hepatitis B virus in healthcare workers vaccinated as adults. Clin Infect Dis 2015 Feb 15; 60:505. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

[Δ. Κουναλάκης]

Συνήθως όταν ένα παιδί έρχεται για το ΑΔΥ του σχολείου στην 1η Γυμνασίου ή 1η Λυκείου, εγώ στέλνω και anti-Hbs.
Αν και δεν τα έχω δημοσιεύσει ακόμη, περίπου το 15-20% των παιδιών δεν έχει επαρκή τίτλο αντισωμάτων και χρειάζεται επαναληπτική δόση.
Από ότι καταλαβαίνω το άρθρο, αυτά τα παιδιά ίσως χρειαστούν επανάληψη και σαν ενήλικες.