Hepatitis B vaccine: Immunogenicity and follow-up including two year booster doses in high-risk health care personnel in a London teaching hospital
✍ Scribed by Dr. Elizabeth A. Fagan; Philippa Tolley; Heather M. Smith; Roger Williams; Adrian L. W. F. Eddleston; Marion P. Peters; Jocelyn Coleman; Patricia Elliott
- Publisher
- John Wiley and Sons
- Year
- 1987
- Tongue
- English
- Weight
- 457 KB
- Volume
- 21
- Category
- Article
- ISSN
- 0146-6615
No coin nor oath required. For personal study only.
✦ Synopsis
One hundred forty-four adult health care personnel (aged 18-62 years, median 33 years) considered at high risk of future HBV infection were vaccinated with a plasma-derived hepatitis B vaccine (20 pg HBVax at 0, 1, and 6 months) and followed-up for 2 years. Anti-HBs was present in only 6.9% prior to vaccination, and prescreening to detect this group would not have been cost-effective. At 9 months, 8.3% were nonresponders and a further 9 % had anti-HBs levels <50 mIU/ml. Multivariate analysis showed that age was the single most important determinant of a poor response. In 47 of 52 individuals retested 2 years later, anti-HBs levels had fallen by 80% or more, and in four it had become undetectable. Response to a booster dose at this stage was excellent, with anti-HBs levels 3 months later much higher than at the end of the initial course. Additional booster doses of vaccine in two of the initial nonresponders at 14 and 22 months, respectively, also led to seroconversion. Although a significant proportion of health care workers in this study did not make a satisfactory response to the hepatitis B vaccine, later booster doses were very effective in subsequently increasing anti-HBs levels.