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• W2056316484 abstract "In the recent issue of HEPATOLOGY, Lu et al.1 reported that vaccinees' anti-HBs titer waned gradually following neonatal immunization with plasma-derived hepatitis B vaccine. They suggested determining the vaccinees' anti-HBs status at 10 to 15 years after receiving hepatitis B vaccine and administering one or more booster immunizations for seronegative subjects. Their findings were inconsistent with several recent studies, including one of their previous studies published in 2003, which indicated booster doses were not necessary for adolescents who had received neonatal immunization with plasma-derived hepatitis B vaccine.2-8 In fact, the data shown by Lu et al. do not fully support their proposition. First, they revealed that only one (4%) of the 26 adolescents who had been infected by hepatitis B virus (HBV), i.e., those with anti-HBc, after the age of 18 months became HBsAg-positive. Therefore, in spite of frequent hepatitis B exposure or infection during childhood in this high-risk group, the possibility of becoming a carrier was quite low. Second, their study did not provide any direct evidence to support the hypothesis that adolescents born to HBeAg-positive mothers without a “protective” level of anti-HBs are at high risk to get HBV infection or become HBV carrier. Third, the data from the remaining 113 study subjects seemed not supportive for the conclusion because most of them had unknown maternal HBsAg status and no follow-up tests were performed after the last dose of primary vaccination. Finally, low titer responders to neonatal hepatitis B vaccination usually have a weak response to a booster; therefore, it is hardly expected a booster may have long-termed benefit to this group of vaccinees. The authors drew the conclusions mainly based on the observation of the declining of anti-HBs during the follow-up period. However, the following points should be considered: (1) protection may be dependent on immune memory; and (2) encouragement of safe sex practice other than vaccination, may probably be a more cost-effective method for the prevention of HBV infection among adolescents. The necessity of booster vaccination for prevention of hepatitis B has been a debatable issue in the last decade. As the strategy of booster vaccination may cause an immense impact to national medical resources, its cost-benefit must be cautiously evaluated. Cho-Yu Chan* , Shou-Dong Lee* , * National Yang-Ming University School of Medicine, Taipei, Taiwan, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan." @default.
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• W2056316484 date "2005-01-01" @default.
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• W2056316484 title "More on the need for boosters 15 years after neonatal vaccination" @default.
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• W2056316484 doi "https://doi.org/10.1002/hep.20633" @default.
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