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

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Tohme, Rania A. ; Awosika-Olumo, Debo ; Nielsen, Carrie ; Khuwaja, Salma ; Scott, Jennifer ; Xing, Jian ; Drobeniuc, Jan ; Hu, Dale J. ; Turner, Cynthia ; Wafeeg, Toni ; Sharapov, Umid ; Spradling, Philip R.
• Description:
  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.
  
  
• Subjects:
  Aged Aged, 80 And Over Assisted Living Facilities Disease Outbreaks Female Hepatitis B Hepatitis B Antibodies Hepatitis B Vaccines Humans Male Middle Aged Vaccines, Synthetic

  More +
• Source:
  Vaccine. 29(50):9316-9320.
• Pubmed ID:
  22015390
• Pubmed Central ID:
  PMC4610903
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  29
• Issue:
  50
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a23f6b491cb880c234d3174e432c4fafe75af8a74ee35054499043617a4e2ece
• Download URL:
  https://stacks.cdc.gov/view/cdc/35106/cdc_35106_DS1.pdf
• File Type:
  [PDF - 607.21 KB ]