title: The effect of age on immunologic response to recombinant hepatitis B vaccine: a meta-analysis.
abstract: Hepatitis B vaccine is a key tool for the prevention of hepatitis B infection. Age-associated changes in immune function may contribute to decreased vaccine efficacy in older individuals, although research related to this topic has yielded contradictory findings. We performed a meta-analysis of 24 published trials and studies that evaluated the association of age with response to hepatitis B vaccine, using a random-effects model. Pooling of study results suggested a significantly increased risk of nonresponse to hepatitis B vaccine among older individuals (relative risk [RR], 1.76; 95% confidence interval [CI], 1.48-2.10). An elevated risk of nonresponse persisted even after exclusion of poor-quality studies (RR, 1.63; 95% CI, 1.23-2.15) and adjustment for publication bias (RR, 1.52; 95% CI, 1.26-1.83), and it was present even when "older" individuals were defined as being as young as 30 years. These findings have important implications for individuals at risk for hepatitis B infection, including health care workers and travelers.
authors.affiliation: City of Hamilton Social and Public Health Services Department, Hamilton, Ontario, Canada. dfisman@city.hamilton.on.ca
authors.forename: David N
authors.initials: DN
authors.lastname: Fisman
authors.forename: Deepak
authors.initials: D
authors.lastname: Agrawal
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D007109:Immunity; D008875:Middle Aged; D011994:Recombinant Proteins / Q000276:immunology
chemical_list: D017325:Hepatitis B Vaccines; D011994:Recombinant Proteins