Long-term immunogenicity of inactivated hepatitis A vaccine: Follow-up at 15 years

Kathy K. Byrd; Dana L. Bruden; Michael G. Bruce; Lisa R. Bulkow; Carolyn L. Zanis; Mary M. Snowball; Chriss E. Homan; Thomas W. Hennessy; James L. Williams; Eitel Dunaway; Sandra S. Chaves; Brian J. McMahon

doi:10.3233/JPI-2010-0269

Journal of Pediatric Infectious Diseases, Table of Contents

J Pediatr Infect Dis 2010; 05(04): 321-326
DOI: 10.3233/JPI-2010-0269

Georg Thieme Verlag KG Stuttgart – New York

Long-term immunogenicity of inactivated hepatitis A vaccine: Follow-up at 15 years

Kathy K. Byrd

^aArctic Investigations Program, Division of Emerging Infections and Surveillance Services, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA

^bEpidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (USDHHS), Atlanta, Georgia, USA

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Dana L. Bruden

^aArctic Investigations Program, Division of Emerging Infections and Surveillance Services, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA

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Michael G. Bruce

^aArctic Investigations Program, Division of Emerging Infections and Surveillance Services, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA

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Lisa R. Bulkow

^aArctic Investigations Program, Division of Emerging Infections and Surveillance Services, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA

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Carolyn L. Zanis

^aArctic Investigations Program, Division of Emerging Infections and Surveillance Services, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA

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Mary M. Snowball

^cLiver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA

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Chriss E. Homan

^cLiver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA

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Thomas W. Hennessy

^aArctic Investigations Program, Division of Emerging Infections and Surveillance Services, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA

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James L. Williams

^cLiver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA

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Eitel Dunaway

^aArctic Investigations Program, Division of Emerging Infections and Surveillance Services, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA

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Sandra S. Chaves

^dDivision of Viral Hepatitis, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (USDHHS), Atlanta, Georgia, USA

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Brian J. McMahon

^aArctic Investigations Program, Division of Emerging Infections and Surveillance Services, National Center for Preparedness, Detection and Control of Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska, USA

^cLiver Disease and Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, Alaska, USA

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Abstract

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Abstract

We conducted a 10–15 years follow-up to a long-term prospective cohort study on the immunogenicity of inactivated hepatitis A vaccine in Alaska Native children, who were initially vaccinated between 3–6 years of age. Children received three vaccine doses (320 E.U.) and were randomized into the following vaccination schedules: A (0, 1, 2 months); B (0, 1, 6 months); and C (0, 1, 12 months). Sera were collected every 2 years and tested for hepatitis A virus (anti-HAV). Levels ≥ 20 mIU/mL were considered protective. Anti-HAV geometric mean concentrations were compared by vaccination schedule at 10, 12 and 14 years of follow-up, using ANOVA. Antibody decline over the entire 15-year follow-up period was also analyzed. While none of the inter-schedule comparisons differed significantly from each other at the 10, 12 and 14-year periods, schedules B and C had significantly higher anti-HAV levels than schedule A over the entire 15 years of the study (P < 0.01). All schedule B and C children maintained seroprotective levels in all follow-up periods. Fourteen percent of schedule A children fell below seroprotective levels at 14 years. Our model estimated that anti-HAV geometric mean concentrations would fall below seroprotective levels at 26, 30 and 32 years for schedules A, B and C, respectively. The data indicate that hepatitis A immunity lasts at least 15 years after vaccination in children and that a booster dose is not needed during that time. However, continued monitoring is necessary to assess the need for a booster dose later in the second and third decade after receipt of the primary series.

Keywords

Hepatitis A - inactivated hepatitis A vaccine - immunogenicity

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