Hepatitis B vaccine immunogenicity among adults vaccinated during an outbreak response in an assisted living facility—Virginia, 2010

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Bender, Thomas John ; Sharapov, Umid ; Utah, Okey ; Xing, Jian ; Hu, Dale ; Rybczynska, Jolanta ; Drobeniuc, Jan ; Kamili, Saleem ; Spradling, Philip R. ; Moorman, Anne C.
• Description:
  Background
  
  Failure to adhere to infection control guidelines, especially during assisted monitoring of blood glucose, has caused multiple hepatitis B outbreaks in assisted living facilities (ALFs). In conjunction with the response to such an outbreak at an ALF (“Facility X”) where most residents had neuropsychiatric disorders, we evaluated seroprotection rates conferred by hepatitis B vaccine and assessed the influence of demographic factors on vaccine response.
  
  Methods
  
  Residents were screened for hepatitis B and C infection, and those susceptible were vaccinated against hepatitis A and hepatitis B with one dose of TWINRIX™ (GSK) given at 0, 1, and 7 months. Blood samples were collected 1–2 months after receipt of the third vaccine dose to test for antibody to hepatitis B surface antigen (anti-HBs).
  
  Results
  
  Of the 27 residents who had post-vaccination blood specimens collected, 22 (81%) achieved anti-HBs concentrations ≥10 mIU/mL. Neither age nor neuropsychiatric comorbidity was a significant determinant of seroprotection. Geometric mean concentration was lower among residents aged 60–74 years (74.3 mIU/mL) than among residents aged 46–59 years (105.3 mIU/mL) but highest among residents aged ≥75 years (122.5 mIU/mL). The effect of diabetes on vaccination response could not be examined because 16/17 (94%) diabetic residents had HBV infection by the time of investigation.
  
  Conclusions
  
  Adult vaccine recipients of all ages, even those over 60 years of age, demonstrated a robust capacity for achieving hepatitis B seroprotection in response to the combined hepatitis A/hepatitis B vaccine. The role for vaccination in interrupting HBV transmission during an outbreak remains unclear, but concerns about age-related response to hepatitis B vaccine may be insufficient to justify foregoing vaccination of susceptible residents of ALFs.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Assisted Living Facilities Disease Outbreaks Female Hepatitis B Hepatitis B Antibodies Hepatitis B Surface Antigens Hepatitis B Vaccines Humans Male Middle Aged Vaccination Virginia

  More +
• Keywords:
  Age HBV Neuropsychiatric
• Source:
  Vaccine. 32(7):852-856
• Pubmed ID:
  24370706
• Pubmed Central ID:
  PMC5719870
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  32
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9991a31e8ed4a4ee483820483b40c3a08cdfeb95def938e40e27a6c4d2ac828c
• Download URL:
  https://stacks.cdc.gov/view/cdc/50496/cdc_50496_DS1.pdf
• File Type:
  [PDF - 189.56 KB ]