Immune persistence induced by three doses of 60 μg hepatitis B vaccine in non-responders following standard primary vaccination in Chinese adults

Figures & data

Figure 1. Participant flow through the initial and follow-up studies

Table 1. Comparison of demographic characteristics between the follow-up group and the lost group in 2014 and 2019

Characteristic	2014		2019
	Follow-up group	Lost group	Follow-up group	Lost group
N	276	135	239	172
Age (years)
Mean (95%CI)	43.3 (42.1–44.4)	40.9 (39.0–42.9)	44.2 (42.9–45.4)	39.9 (38.2–41.7)
Sex
Male, n (%)	137 (49.6)	72 (53.3)	131 (54.8)	78 (45.3)
Female, n (%)	139 (50.36)	63 (46.7)	108 (45.2)	94 (54.7)
BMI (kg/m^2)
Mean (95%CI)	24.5 (24.1–24.9)	24.2 (23.6–24.9)	24.4 (24.0–24.9)	24.3 (23.7–24.9)

BMI = body mass index. 2014 = 6 years after receiving the third dose of 60 μg HB vaccine; 2019 = 11 years after receiving the third dose of 60 μg HB vaccine.

Table 2. Seropositive rates and anti-HBs concentrations (mIU/ml) in 2008, 2014, and 2019

	2008 (N = 428)	2014 (N = 276)	2019 (N = 239)	P value
Seropositive rate n (%)	411 (96)	133 (48.2)	97 (40.6)	<0.001
GMC (mIU/ml)	584.0 ± 374.0	142.4 ± 248.7	169.1 ± 277.9	<0.001

Data are n (%) or means±SD. 2008 = 28 days after receiving the third dose of 60 μg HB vaccine; 2014 = 6 years after receiving the third dose of 60 μg HB vaccine; 2019 = 11 years after receiving the third dose of 60 μg HB vaccine.

Table 3. Seropositive rates and anti-HBs concentrations (mIU/ml) in 181 individuals vaccinated in 2008 and retested in 2014 and in 2019

	2008	2014	2019	P value
Seropositive rate n (%)	180 (99.4)	90 (49.7)	70 (38.7)	<0.001
GMC (mIU/ml)	588.4 ± 360.8	134.9 ± 239.6	156.6 ± 262.5	<0.001

Data are n (%) or means±SD. 2008 = 28 days after receiving the third dose of 60 μg HB vaccine; 2014 = 6 years after receiving the third dose of 60 μg HB vaccine; 2019 = 11 years after receiving the third dose of 60 μg HB vaccine.

Figure 2. Classification of participants based on their serum concentration of anti-HBs antibody in 2008, 2014 and 2019. 2008 = 28 days after receiving the third dose of 60 μg HB vaccine; 2014 = 6 years after receiving the third dose of 60 μg HB vaccine; 2019 = 11 years after receiving the third dose of 60 μg HB vaccine. According to the titer of anti-HBs, the body’s response to HB vaccine can be divided into four states: <10 mIU/ml = non-responders; 10–100 mIU/ml = low-responders; 100–1000 mIU/ml = moderate responders; ≥1000 mIU/ml = high-responders

Table 4. Logistic regression analysis of seropositive rate of anti-HBs in 2019 with the baseline characters

			OR
Model parameters	SE	P value	Point estimates	95%CI by Wald
Intercept	0.27	0.77	0.93
Age	0.29	0.82	1.07	0.61–1.88
Sex	0.28	0.01	0.46	0.27–0.80

The occurrence of anti-HBs level ≥10 mIU/ml is the dependent variable. The independent variables are age (stratified into ≤40, >40; using >40 years as reference) and sex (female as reference). 2019 = 11 years after receiving the third dose of 60 μg HB vaccine.