Evaluation of hepatitis B vaccine immunogenicity among older adults during an outbreak response in assisted living facilities.

Abstract:

BACKGROUND:During the past decade, in the United States, an increasing number of hepatitis B outbreaks have been reported in assisted living facilities (ALFs) as a result of breaches in infection control practices. We evaluated the seroprotection rates conferred by hepatitis B vaccine among older adults during a response to an outbreak that occurred in multiple ALFs and assessed the influence of demographic and clinical factors on vaccine response. METHODS:Residents were screened for hepatitis B and C infection prior to vaccination and susceptible residents were vaccinated against hepatitis B with one dose of 20 μg Engerix-B™ (GSK) given at 0, 1, and 4 months. Blood samples were collected 80-90 days after the third vaccine dose to test for anti-HBs levels. RESULTS:Of the 48 residents who had post-vaccination blood specimens collected after the third vaccine dose, 16 (33.3%) achieved anti-HBs concentration ≥10 mIU/mL. Age was a significant determinant of seroprotection with rates decreasing from 88% among persons aged ≤60 years to 12% among persons aged ≥90 years (p=0.001). Geometric mean concentrations were higher among non-diabetic than diabetic residents, however, the difference was not statistically significant (5.1 vs. 3.8 mIU/mL, p=0.7). CONCLUSIONS:These findings highlight that hepatitis B vaccination is of limited effectiveness when administered to older adults. Improvements in infection control and vaccination at earlier ages might be necessary to prevent spread of infection in ALFs.

journal_name

Vaccine

journal_title

Vaccine

authors

Tohme RA,Awosika-Olumo D,Nielsen C,Khuwaja S,Scott J,Xing J,Drobeniuc J,Hu DJ,Turner C,Wafeeg T,Sharapov U,Spradling PR

doi

10.1016/j.vaccine.2011.10.011

subject

Has Abstract

pub_date

2011-11-21 00:00:00

pages

9316-20

issue

50

eissn

0264-410X

issn

1873-2518

pii

S0264-410X(11)01605-7

journal_volume

29

pub_type

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