title: Ethnicity, substance use, and response to booster hepatitis B vaccination in anti-HBs-seronegative adolescents who had received primary infantile vaccination.
abstract: OBJECTIVE
  In this revaccination study, we explored the determinants of response to booster hepatitis B (HB) vaccination in anti-HBs-seronegative adolescents who had received primary HB vaccination 15-18 years before.
  
  
  RESULTS
  After controlling for prebooster anti-HBs levels, cigarette smoking, betel-quid chewing, alcohol drinking, and indigenous ethnicity were significantly associated with elevated risks of non-response to booster HB vaccination. The adjusted odds ratios (aORs) were 3.21 (CI: 1.33-7.84), 8.78 (CI: 2.03-37.94), 2.64 (CI: 1.15-6.02), and 2.46 (CI: 1.28-4.72), respectively. Among adolescents with undetectable prebooster anti-HBs titers, only indigenous ethnicity significantly associated with elevated risk, with an adjusted OR of 2.57 (CI: 1.20-5.54), of non-response to booster HB vaccination. On the contrary, the influences of cigarette smoking, betel-quid chewing, and alcohol drinking were restricted to adolescents with prebooster anti-HBs titers of 0.1-9.9mIU/mL. The corresponding multivariate-adjusted ORs were 5.70, 17.41, and 3.72, respectively. Adolescents who smoked cigarettes and chewed betel-quid were at highest risk of non-response (aOR, 25.3; CI: 2.97-215.7).
  
  
  CONCLUSIONS
  A booster dose of HB vaccine may be insufficient to induce immunological response in healthy adolescents who had undetectable prebooster anti-HBs titers or who were of Malay-Polynesian ethnicity. Responses to booster vaccination are probably modified by recent cigarette smoking and/or betel-quid chewing.
authors.affiliation: Graduate Institute of Aboriginal Health, Tzu Chi University, 701, Section 3 Chung Yang Road, Hualien 970, Taiwan. yannbo@mail.tcu.edu.tw
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Wang
authors.forename: Hans Hsienhong
authors.initials: HH
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D005260:Female; D006509:Hepatitis B / Q000208:ethnology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000737:chemistry; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D007107:Immune System; D007117:Immunization, Secondary; D008297:Male; D015233:Models, Statistical; D016017:Odds Ratio; D012044:Regression Analysis; D012907:Smoking; D014611:Vaccination; D014612:Vaccines / Q000737:chemistry
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D014612:Vaccines