title: Determinants of Long-term protection after hepatitis B vaccination in infancy: a meta-analysis.
abstract: BACKGROUND
  The duration of protection after hepatitis B vaccination in early infancy is unclear and may be related to vaccination schedule, dosage, vaccine type and population characteristics. Factors potentially influencing waning immunity were assessed.
  
  
  METHODS
  A systematic review was performed. The main outcomes were prevalence of anti-hepatits B antibodies ≥ 10 mIU/mL after primary or booster vaccination. Factors potentially influencing protection were assessed in an adjusted random-effects meta-analysis model by age for both outcomes. Results of both meta-analyses were combined in a prognostic model.
  
  
  RESULTS
  Forty-six studies reporting on the anti-hepatits B antibodies ≥ 10 mIU/mL 5 to 20 years after primary immunization and 29 on booster response were identified. The adjusted meta-analyses identified maternal carrier status (odds ratio [OR]: 2.37 [1.11; 5.08]), lower vaccine dosage than presently recommended (OR: 0.14 [0.06; 0.30]) and gap time between last and preceding dose of the primary vaccine series (OR: 0.44 [0.22; 0.86]) as determinants for persistence of anti-hepatits B antibodies ≥ 10. A lower vaccine dosage was also associated with failure to respond to booster (OR: 0.20 [0.10; 0.38]). The prognostic model predicted long-term protection of 90% [77%; 100%] at the age of 17 years for offspring of noncarrier mothers vaccinated with a presently recommended dose and vaccination schedule.
  
  
  CONCLUSIONS
  Based on meta-analyses, predictors of waning immunity after hepatitis B vaccination in infancy could be identified. A prognostic model for long-term protection after hepatitis B vaccination in infancy was developed.
authors.affiliation: Institute of Social Pediatrics and Adolescent Medicine, Division of Epidemiology, Biostatistics and Epidemiology, Ludwig Maximilians University of Munich, Germany. schoenberger@med.uni-muenchen.de
authors.forename: Katharina
authors.initials: K
authors.lastname: Schönberger
authors.forename: Christina
authors.initials: C
authors.lastname: Riedel
authors.forename: Simon
authors.initials: S
authors.lastname: Rückinger
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mansmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jilg
authors.forename: Rüdiger V
authors.initials: RV
authors.lastname: Kries
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D007156:Immunologic Memory; D007223:Infant; D008297:Male; D015233:Models, Statistical; D016036:Seroepidemiologic Studies; D013997:Time Factors; D014611:Vaccination / Q000379:methods*; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines