Duration of protection against hepatitis A for the current two-dose vaccine compared to a three-dose vaccine schedule in children

Vaccine. 2013 Apr 19;31(17):2152-5. doi: 10.1016/j.vaccine.2013.02.048. Epub 2013 Mar 5.

Abstract

Background: Hepatitis A is mostly a self-limiting disease but causes substantial economic burden. Consequently, United States Advisory Committee for Immunization Practices recommends inactivated hepatitis A vaccination for all children beginning at age 1 year and for high risk adults. The hepatitis A vaccine is highly effective but the duration of protection is unknown.

Methods: We examined the proportion of children with protective hepatitis A antibody levels (anti-HAV ≥20 mIU/mL) as well as the geometric mean concentration (GMC) of anti-HAV in a cross sectional convenience sample of individuals aged 12-24 years, who had been vaccinated with a two-dose schedule in childhood, with the initial dose at least 5 years ago. We compared a subset of data from persons vaccinated with two-doses (720 EL.U.) at age 3-6 years with a demographically similar prospective cohort that received a three-dose (360 EL.U.) schedule and have been followed for 17 years.

Results: No significant differences were observed when comparing GMC between the two cohorts at 10 (P=0.467), 12 (P=0.496), and 14 (P=0.175) years post-immunization. For the three-dose cohort, protective antibody levels remain for 17 years and have leveled-off over the past 7 years.

Conclusion: The two- and three-dose schedules provide similar protection >14 years after vaccination, indicating a booster dose is not needed at this time. Plateauing anti-HAV GMC levels suggest protective antibody levels may persist long-term.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hepatitis A / immunology*
  • Hepatitis A / prevention & control*
  • Hepatitis A Antibodies / immunology
  • Hepatitis A Vaccines / administration & dosage*
  • Hepatitis A Vaccines / immunology*
  • Humans
  • Immunization Schedule*
  • Male
  • Prospective Studies
  • Time Factors
  • United States
  • Vaccination*
  • Vaccines, Inactivated / administration & dosage
  • Vaccines, Inactivated / immunology
  • Young Adult

Substances

  • Hepatitis A Antibodies
  • Hepatitis A Vaccines
  • Vaccines, Inactivated