title: Duration of protection from clinical hepatitis A disease after vaccination with VAQTA.
abstract: Recent papers examining the expected persistence of anti-hepatitis A virus antibody following vaccination with inactivated hepatitis A vaccine have estimated that geometric mean antibody levels will remain above cut-off levels for 10-30 years. However, the methodology used in these papers did not take into account any estimates of variability between subjects. In this paper data from the persistence of antibody after the administration of another vaccine, VAQTA (hepatitis A vaccine, inactivated; MSD), were used to develop further models of antibody decay. Using individual subject estimates instead of group means allowed the estimation of time to negativity for various percentiles of the population (including the median), and the construction of confidence intervals on estimates of time to negativity. Data from studies of subjects who seroreverted to negativity, and subsequently received a booster dose, were also considered to show that subjects who lose detectable antibody are likely to remain protected from hepatitis A disease by persistent immune memory and rapid anamnestic response soon after exposure to hepatitis A virus. The estimates of duration of protection suggest that VAQTA will provide protection for many years, first through presence of antibody and further through an anamnestic response based on persistent immune memory.
authors.affiliation: Department of Clinical Biostatistics, Merck Research Laboratories, West Point, Pennsylvania, USA.
authors.forename: B L
authors.initials: BL
authors.lastname: Wiens
authors.forename: N R
authors.initials: NR
authors.lastname: Bohidar
authors.forename: J G
authors.initials: JG
authors.lastname: Pigeon
authors.forename: J
authors.initials: J
authors.lastname: Egan
authors.forename: W
authors.initials: W
authors.lastname: Hurni
authors.forename: L
authors.initials: L
authors.lastname: Brown
authors.forename: B J
authors.initials: BJ
authors.lastname: Kuter
authors.forename: D R
authors.initials: DR
authors.lastname: Nalin
mesh_terms: D006506:Hepatitis A / Q000517:prevention & control*; D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies / Q000097:blood*; D006801:Humans; D013997:Time Factors; D014611:Vaccination; D015164:Vaccines, Inactivated / Q000276:immunology*; D014761:Viral Hepatitis Vaccines / Q000276:immunology*
chemical_list: D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines