Response to a booster dose 18 months after a low anti-HBs response (10–99 IU/l) to three doses of intradermally or intramuscularly administered recombinant hepatitis B vaccine

Struve, Johan; Aronsson, B; Frenning, B; Forsgren, Marianne; Weiland, Ola

doi:10.1007/bf01710057

Cited by 13 publications

(4 citation statements)

References 22 publications

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“…Research in Europe and the USA has demonstrated that subjects who appear unresponsive or minimally responsive to the primary three‐dose hepatitis B vaccination account for 5–15% of vaccinees 22,23 . However, these individuals are not necessarily absolute non‐responders: the majority can develop protective levels of anti‐HBs after additional hepatitis B vaccination, consisting of a fourth or fifth dose, or an additional complete course of vaccination 21,24,25 . Administration of these additional doses of vaccine to low‐level or non‐responders can, in most cases, result in adequate antibody response and immunological priming 6 .…”

Section: Non‐respondersmentioning

confidence: 99%

Hepatitis B vaccine boosters: Is there a clinical need in high endemicity populations?

John

Cooksley

2005

J of Gastro and Hepatol

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The Steering Committee for the Prevention and Control of Infectious Diseases in Asia recently conducted a survey of primary-care physicians in Asia, which revealed that many physicians administer boosters in their clinical practice and that there is considerable variation and uncertainty among physicians regarding this practice. This paper serves as a response to physicians' uncertainties by reviewing the literature regarding the administration of hepatitis B vaccine boosters in high endemicity areas and presenting the Steering Committee's guidelines for booster administration. While there are few data to support a need for routine hepatitis B vaccine boosters as a public health measure, they help to provide reassurance of immunity against breakthrough infection in certain risk groups. In clinical practice, primary-care physicians must exercise their judgment regarding the need for booster vaccination on an individual basis. This paper examines the available literature on the administration and value of hepatitis B vaccine boosters, explores the differences between the public health approach and clinical practice, and provides guidelines for those who use boosters in high endemicity Asian populations. Relevant articles were identified through searches of MEDLINE (1975MEDLINE ( -2003 and the Cochrane Library, using 'hepatitis B' and 'booster' as primary search terms. Guidelines for those who decide to administer hepatitis B vaccine boosters include: boosting approximately 10-15 years after primary vaccination; boosting rather than not when monitoring of antibody levels is not feasible; boosting immunocompromised patients when the antibody to hepatitis B surface antigen titer falls below 10 mIU/mL; and boosting healthcare workers based on the endemicity of the particular country.

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Section: Non‐respondersmentioning

confidence: 99%

Hepatitis B vaccine boosters: Is there a clinical need in high endemicity populations?

John

Cooksley

2005

J of Gastro and Hepatol

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“…Among medical students immunized id with 2 µg of plasma-derived vaccine, 63% and 85% had ≥ 10 mIU of anti-HBs/ml 30 and 20-24 months after primary immunization, respectively [9,10]. Struve et al [11] reported that seroconversion could be achieved in 50% of nonresponders to primary three doses (0, 1 and 6 months) im or id with an additional 1 to 2 doses by the same route as the initial vaccination.They also reported that 86% of the id vaccinees had anti-HBs below 10 IU/l after 18 months and 90% of them had increased to protective levels with a booster dose [12]. We administered additional doses to reassure protective immunity in those medical students with nonprotective titers after the primary doses.…”

Section: Discussionmentioning

confidence: 81%

Low-Dose Intramuscular Hepatitis B Vaccination in Medical Students: 4-Year Follow-Up

Erensoy¹,

Bilgiç²,

Arda³

et al. 2002

Infection

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“…The inconveniences of the patients (the risk of allergic reactions and other adverse effects as fatigue and myalgia) and the low risk of acquiring hepatitis B in Sweden (less than 10 cases/100 000 inhabitants per year 1990-94) (17) questions the necessity of hepatitis B vaccination in Swedish dialysis patients. So do the low rate of success, the low levels of response shown by us and others as well as a low persistence in time of antibodies in low level antibody responders (30) and the expense of such programs. Renal patients have been shown to have a low persistence of antibodies also with vaccine to pneumococci (31).…”

Section: Discussionmentioning

confidence: 91%

Perspectives on Hepatitis B Infections and the Efficacy of Vaccination (Hepatitis B and Pneumococci) in Dialysis Patients

Almroth¹,

Uhlin²,

Ekermo³

et al. 2003

Upsala Journal of Medical Sciences

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Hepatitis B is a well known problem in dialysis units. We therefore examined the historical frequency of hepatitis B carriers in our unit, our vaccination program to hepatitis B virus (HBV), the response to hepatitis B vaccine, the IgG subclass response of anti-HBs and the response and IgG subclass response to pneumococcal vaccination (another vaccine) in dialysis patients. From 1970 and onwards 23 HBV carriers were found, but no new cases of hepatitis B occurred during the study period, i.e. from 1980 and onwards. Only one of the carriers was alive by the end of 2001. In four patients liver disease (in one of them liver cirrhosis) may have been a concomitant cause of death. The antibody response to hepatitis B vaccine was significantly lower in patients than in staff. In four patients a fourth injection was cancelled due to transplantation and bad health, while such data were lacking in 8 cases. In anti-HBs positive patients and controls a significant difference in the response of healthy adults was observed in anti-HBs IgG1 (p < 0.001) vs all other IgG subclasses. Dialysis patients had low levels, or negative findings, in all cases, with IgG1 as the highest proportion found (3/11 patients). An antibody response to pneumococcal vaccination was registered in 25 out of 29 dialysis patients (in all 86%). The IgG-subclass vaccination response to pneumococci in 28 dialysis patients was mainly IgG2 and IgG1 but also occurred in IgG3 and IgG4. Prevaccination antibody levels of the controls were higher in IgG1 and IgG2 (p < 0.01) (n = 21) than in dialysis patients (n = 28). Hepatitis B is nowadays a rare, but still dangerous disease in nephrology units. Dialysis patients have a reduced response to hepatitis B vaccine and vaccination schedules should be started early as some patients otherwise may not receive a fourth injection. The adequate antibody response to pneumococcal vaccination mainly due to IgG2 and IgG1 antibodies indicates that the antigen involved is important in vaccination responses in dialysis patients.

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Response to a booster dose 18 months after a low anti-HBs response (10–99 IU/l) to three doses of intradermally or intramuscularly administered recombinant hepatitis B vaccine

Cited by 13 publications

References 22 publications

Hepatitis B vaccine boosters: Is there a clinical need in high endemicity populations?

Hepatitis B vaccine boosters: Is there a clinical need in high endemicity populations?

Low-Dose Intramuscular Hepatitis B Vaccination in Medical Students: 4-Year Follow-Up

Perspectives on Hepatitis B Infections and the Efficacy of Vaccination (Hepatitis B and Pneumococci) in Dialysis Patients

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