Liver and Bile
Protection and antibody levels 35 years after primary series with hepatitis B vaccine and response to a booster dose
Background and aims: The duration of protection from hepatitis B vaccination in children and adults is not known. In 1981, the authors used 3 doses of plasma-derived hepatitis B vaccine to immunize a cohort of 1578 Alaska Native adults and children from 15 Alaska communities who were ≥ 6 months old.
Approach and results: They tested persons for antibody to hepatitis B surface antigen (anti-HBs) levels 35 years after receiving the primary series. Those with levels < 10 mIU/ml received 1 booster dose of recombinant hepatitis B vaccine 2–4 weeks later and were then evaluated on the basis of anti-HBs measurements 30 days postbooster. Among the 320 recruited, 112 persons had not participated in the 22- or 30-year follow-up study (group 1), and 208 persons had participated but were not given an HBV booster dose (group 2). Among the 112 persons in group 1 who responded to the original primary series, 53 (47.3%) had an anti-HBs level ≥ 10 mIU/ml. Among group 1, 73.7% of persons (28/38) available for a booster dose responded to it with an anti-HBs level ≥ 10 mIU/ml at 30 days. Initial anti-HBs level after the primary series was correlated with higher anti-HBs levels at 35 years. Among 8 persons who tested positive for antibody to hepatitis B core antigen, none tested positive for HBsAg or HBV DNA.
Conclusions: Based on anti-HBs level ≥ 10 mIU/ml at 35 years and a 73.7% booster dose response, it was estimated that 86% of participants had evidence of protection 35 years later. Booster doses are not needed in the general population at this time.