Hepatitis B vaccine immunoresponsiveness in adolescents: a revaccination proposal after primary vaccination

doi:10.1016/0264-410X(95)00176-2

Vaccine

Volume 14, Issue 2, February 1996, Pages 103-106

https://doi.org/10.1016/0264-410X(95)00176-2 Get rights and content

Abstract

Hepatitis B recombinant vaccine immunoresponsiveness was studied in 427 preadolescents vaccinated with a 0,1 and 6 months vaccination schedule. AntiHBs postvaccination titres (measured one month after the last dose) were related to the following variables: sex; weight; height; and Quetelet index. The antiHBs postvaccination titres were used to predict the length of protection induced by the vaccine. All preadolescents developed antiHBs titres 10 IUl⁻¹ and no statistically significant differences could be found between sexes. The relation study between antiHBs postvaccination levels and Quetelet index showed a statistically significant inverse correlation. According to the antiHBs postvaccination titres, the central 50% of the sample distribution would be protected during a period between 7.5 and 10.5 years. In pre-teenagers, the hepatitis B recombinant vaccine has proven to be highly immunogenic, obesity is a predictor of poor immunoresponse and this response is not influenced by sex. According to our results, we would propose the administration of a single booster dose 10 years after primary vaccination and thus protect these subjects during the period of greatest risk.

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Cited by (51)

Impact of body mass index on immunogenicity of hepatitis B vaccine in bariatric surgery candidates: A retrospective study
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Citation Excerpt :
In addition, the positive-HBsAb group was younger, had a higher proportion of women, obese and overweight cases, as well as more recipients of a 3-dose HB vaccine, compared with negative-HBsAb participants. After adjusting for confounding factors, the results of the present study also revealed that BMI was not an independent determinant of vaccine-induced immune response among both negative and positive HBsAb titer groups; these findings are in agreement with some previous related studies [11,18–22]. Similarly, Nashibi et al. observed no considerable association between BMI and poor seroprotection following HBV vaccine among medical staff [18].
Hepatitis B virus (HBV) immunization is regarded as the most effective method for the prevention of HBV infection. Various factors, including body mass index (BMI), may contribute to decreased immunization responses. This study aimed to investigate the relationship between BMI at the time of vaccination with anti-HBs levels over the following years.
In this retrospective study, 790 vaccinated participants were recruited. Of these, individuals were selected whose hepatitis B antibody (HBsAb) information was available in 2017. The researchers contacted participants by phone to gather data regarding vaccination history, and weight at the time of vaccination. All data analysis was performed by SPSS.
This study included 165 eligible adults (28 males and 137 females). Among them, 79% participants were obese. Additionally, 46 (27.88%) and 119 (72.12%) had negative and positive HBsAb, respectively. There were no statistically significant differences seen across all characteristics, except for the number of HBV vaccinations between the positive and negative HBsAb groups. Multiple logistic regression also indicated no meaningful relationship between BMI and positive antibodies.
There was no relationship observed between BMI and immune response to HBV vaccine in bariatric candidates. Known risk factors (age, sex, diabetes, and the number of HBV vaccinations) were not independent predictors of the antibody response to the HBV vaccine.
Good response to the primary course and booster dose of hepatitis B vaccine in children with non-alcoholic fatty liver disease
2017, Digestive and Liver Disease
Hepatitis B vaccine response in obesity: A meta-analysis
2016, Vaccine
Citation Excerpt :
As the most effective means to protect people from HBV infection, the program on immunization with recombinant hepatitis B vaccine was instituted in more than 200 counties since 1982. These efforts resulted in a remarkable decrease of HBsAg positivity worldwide, especially in children and adolescents [3–6]. Obesity is a major health problem worldwide [7,8].
Hepatitis B vaccination is critical in preventing hepatitis B virus (HBV) infection and transmission. However, the impact of obesity on immune response to hepatitis B vaccine remains unclear.
We performed a meta-analysis of the literature and summarized the results of immune response to hepatitis B vaccine among persons with and without obesity. We used Pubmed, Embase, Web of Science and Cochrane Library to identify all related studies between January 1973 and November 2015. Unadjusted and adjusted pooled OR and 95% CI were calculated by fixed-effect model or random-effect model according to the heterogeneity of the selected studies.
Totally, 16 studies contributed to the present meta-analysis. Fifteen of them provided absolute numbers of non-responders in obese group and non-obese group. Overall, we found that the obese population was significantly associated with non-response to hepatitis B vaccination (adjusted OR: 2.46, 95% CI: 1.50–4.03). Significant heterogeneity was present in most of the pooled analyses, but was markedly reduced when analyses were restricted to study reports with uniform criteria of obesity and restricted to study in adults. No publication bias was observed in the present analysis.
The present meta-analysis suggested that obesity is significantly associated with the decreased response to hepatitis B vaccines. Future studies should be performed to unravel this relationship in order to prevent HBV infection and transmission.
Pediatric Obesity: Pharmacokinetics and Implications for Drug Dosing
2015, Clinical Therapeutics
Citation Excerpt :
This case report suggests that obese children may still derive benefit from this drug. Minana et al84 studied 427 children to examine hepatitis B vaccine immune response and duration of protection in obese versus normal-weight children (Table IX). There was a weak correlation between BMI and hepatitis B surface antigen antibodies; however, all children had concentrations of these antibodies above the recommended 10 IU/L.
Clinicians are increasingly likely to have under their care obese children with diseases requiring pharmacotherapy. Optimal drug dosing for this population is unclear. Excess weight likely leads to alterations in pharmacokinetics. The purpose of this article was to describe the pharmacokinetics and pharmacodynamics in overweight and obese children and, where possible, provide recommendations for drug dosing.
EMBASE (1980–May 2015), MEDLINE (1950–May 2015), and International Pharmaceutical Abstracts (1970–May 2015) databases were searched by using the following terms: obesity, morbid obesity, overweight, pharmacokinetics, pharmacodynamics, drug, dose, drug levels, pediatric, and child. The search was limited to English-language articles. References of relevant articles were searched to identify additional studies.
Total body weight (TBW) is an appropriate size descriptor for dosing antineoplastic agents, succinylcholine, and cefazolin. Obese children seem to require less heparin, enoxaparin, and warfarin per kilogram TBW than normal-weight children; providing standard adult doses may be insufficient, however. Obese children may also require less vancomycin and aminoglycosides per kilogram TBW than normal-weight children. For these medications, an alternate size descriptor in children has not been described, and initial dosing based on TBW and monitoring serum concentrations (vancomycin and aminoglycosides) or coagulation parameters (heparin, enoxaparin, and warfarin) is warranted. Obese children require less propofol than normal-weight children; however, there is limited information about the dosing of other anesthetics or opioids.
Limitations to the available data include the inherent design constraints to case reports and retrospective cohort studies, as well as the small numbers of children in some of the studies. Use of normal-weight historical control subjects for obese children in the context of a pharmacokinetic study is not ideal. Although more information is becoming available, our understanding of the pharmacokinetics in obese children is still limited. When dosing information is not available for obese children, it may be necessary to extrapolate from available data in obese adults, but one should consider the effects of the child’s age on pharmacokinetics.
The weight of obesity on the human immune response to vaccination
2015, Vaccine
Despite the high success of protection against several infectious diseases through effective vaccines, some sub-populations have been observed to respond poorly to vaccines, putting them at increased risk for vaccine-preventable diseases. In particular, the limited data concerning the effect of obesity on vaccine immunogenicity and efficacy suggests that obesity is a factor that increases the likelihood of a poor vaccine-induced immune response. Obesity occurs through the deposition of excess lipids into adipose tissue through the production of adipocytes, and is defined as a body-mass index (BMI) ≥ 30 kg/m². The immune system is adversely affected by obesity, and these “immune consequences” raise concern for the lack of vaccine-induced immunity in the obese patient requiring discussion of how this sub-population might be better protected.
High prevalence of hepatitis B non-immunity in paediatric non-alcoholic fatty liver disease patients
2014, Digestive and Liver Disease

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PaperHepatitis B vaccine immunoresponsiveness in adolescents: a revaccination proposal after primary vaccination

Abstract

Lancet

Lancet

Lancet

Vaccine

Lancet

Lancet

Hepatitis B vaccination: protection for how long and against what?

Br. Med. J.

Hepatitis por virus B

Gastrum

Obesity as a predictor of poor antibody response to hepatitis B plasma vaccine

J. Am. Med. Assoc.

Suboptimal response to hepatitis B vaccine given by injection in the buttock

Morbid. Mortal. Wkly Rep.

Paper
Hepatitis B vaccine immunoresponsiveness in adolescents: a revaccination proposal after primary vaccination