[NVIC March 2005] Early Hep B Vaccine Immunity Wanes

Vienna, Virginia http://www.nvic.org

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"Protecting the health and informed consent rights of children since 1982."

BL Fisher Note: The policy of vaccinating all healthy newborns and infants
born to healthy mothers with hepatitis B vaccine is not only unnecessary, it
is ineffective over the long term. Hepatitis B is primarily an adult, blood
transmitted disease that is prevalent among IV drug users and those with
multiple sexual partners. Not only did the CDC recommendation of universal
vaccination of all newborns in 1991 subject a whole generation to their
first hit of mercury at 12 hours of age, but now this study shows that
vaccinating children under 4 years of age makes it necessary to revaccinate
them at 15 years of age because vaccine induced immunity is only temporary.
Millions of babies have been vaccinated with hepatitis B during the past 15
years. The national, uncontrolled vaccine experiment on American babies

Original page:
February 28, 2005

Vaccine Stops Hepatitis B for 15 Years

Longer Protection May Reduce Need for Booster Shots

By Miranda Hitti
WebMD Medical News  Reviewed By Brunilda Nazario, MD

The hepatitis B vaccine works for at least 15 years -- longer than once

The vaccine thwarts the virus that causes hepatitis B, a liver disease that
can lead to liver cirrhosis or cancer. Most countries include the vaccine in
their infant immunization programs. It's given in a series of three shots
and was known to protect against hepatitis B for five to 10 years. But no
one knew if it worked beyond that point.

Now, researchers have an answer. The vaccine "strongly protected against
[hepatitis B] infection for at least 15 years in all age groups," they

However, the benefits faded fastest in people vaccinated when they were 4
years old or younger. Researchers will keep an eye on those patients to see
if they need additional doses of the vaccine or booster shots in the future.

The news comes from a study of Alaska natives, who have high rates of
hepatitis B, with most cases starting in early childhood.

A total of 1,578 people participated.

In the early 1980s, participants were fully vaccinated against hepatitis B.
All were at least six months old, and some were in their 20s or older.

After 15 years, the researchers were still in touch with almost half of the
group. The vaccine's protection against infection was still going strong in
84% of those people.

Vaccine Lasts Longer After 5th Birthday

The vaccine's effectiveness waned the most in people vaccinated before their
fifth birthday. "It is important that we continue to follow this group in
order to determine when and if booster doses will be necessary," says the

The report comes from researchers including Brian McMahon, MD, of the CDC's
Arctic Investigations Program. The study appears in the March 1 edition of
the Annals of Internal Medicine.

The finding may spare patients from needless booster shots, says Ding-Shinn
Chen, MD, of National Taiwan University's medical school.

"Unless continued follow-up and surveillance show clinically significant
rates of infection for adolescents who were vaccinated as children, booster
vaccinations will be wasteful," writes Chen in an Annals of Internal
Medicine editorial.

Hepatitis B can be spread through contact with infected body fluids, such as
through sexual contact or shared needles. It can also be spread from an
infected mother to her newborn at the time of birth.

The vaccine is the one of the most effective ways to prevent hepatitis B
infection. It's most effective when all three shots of the vaccine are

For further protection, use a condom when you have sex, don't share needles,
wear plastic or latex gloves if you have to touch blood, and don't share
toothbrushes or razors.


Annals of Internal Medicine, March 1, 2005; vol 142: pp 333-341.

Antibody Levels and Protection after Hepatitis B Vaccination: Results of a
15-Year Follow-up

Background: The duration of protection afforded by hepatitis B vaccination
is unknown.

Objective: To determine antibody persistence and protection from hepatitis B
virus (HBV) infection.

Design: Prospective cohort study.

Setting: 15 villages in southwest Alaska.

Participants: 1578 Alaska Natives vaccinated at age 6 months or older.

Intervention: During 1981-1982, participants received 3 doses of
plasma-derived hepatitis B vaccine. This cohort was followed annually over
the first 11 years, and 841 (53%) persons were tested at 15 years.

Measurements: Antibody to hepatitis B surface antigen (anti-HBs), markers of
HBV infection, and testing to identify HBV variants.

Results: Levels of anti-HBs in the cohort decreased from a geometric mean
concentration of 822 mIU/mL after vaccination to 27 mIU/mL at 15 years.
Initial anti-HBs level, older age at vaccination, and male sex were
associated with persistence of higher anti-HBs levels at 15 years when
analyzed by a longitudinal linear mixed model. After adjustment for initial
anti-HBs level and sex, those vaccinated at age 6 months to 4 years had the
lowest anti-HBs level at 15 years. Asymptomatic breakthrough infections were
detected in 16 participants and occurred more frequently in persons who did
not respond to vaccination than those who responded (P = 0.01). Among
infected persons with viremia, 2 were infected with wild-type HBV and 4 had
HBV surface glycoprotein variants, generally accompanied by wild-type HBV.

Limitations: The loss of participants to follow-up at 15 years was 47%.
However, characteristics of persons tested were similar to those of persons
lost to follow-up.

Conclusions: Hepatitis B vaccination strongly protected against infection
for at least 15 years in all age groups. Antibody levels decreased the most
among persons immunized at 4 years of age or younger.

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