Does the Vaccine Type Change Anything?
When administered as recommended, all hepatitis B vaccines can provide protection from HBV for a lifetime. None is inherently better than the other. However, a 2018 study published in Human Vaccines and Immunotherapeutics reported that among adults vaccinated for hepatitis B, only 41% to 62% completed the series within one year of their first dose.
For this reason alone, many providers recommend Heplisav-B over Engerix-B and Recombivax HB, as it only requires two doses given over a short, one-month time span. A study published in the American Journal of Managed Care reported that 60.5% of adults given Heplisav-B completed the vaccination series compared to only 32.3% of those given Engerix-B.
Reasons Vaccination May Not Last a Lifetime
Just because hepatitis B vaccines should provide lifelong protection doesn’t mean that they always do. The two main reasons for this are:
- The failure to complete the recommended hep B series, which can significantly lower the body’s immune response and the overall effectiveness of the vaccine.
- The failure to achieve an adequate immune response even after the hep B series has been completed.
The latter involves a subset of individuals known as hepatitis B vaccine nonresponders. These are people who do not have hepatitis B but fail to develop enough antibodies after vaccination to prevent infection. It is estimated that between 5% and 10% of people vaccinated for hepatitis B are nonresponders.
Who Are Nonresponders?
People who are nonresponders characteristically have compromised immune systems. Without an intact system to launch a robust immune response to the vaccine, a person will end up producing too few antibodies to avert an infection. According to 2024 research published in the journal Vaccine, the most common reasons for this are:
- Older age: Aging is associated with a natural decline in a type of white blood cell, called a lymphocyte, that forms hepatitis B antibodies.
- Male sex: Males have higher nonresponse rates than females.
- Obesity: Chronic inflammation spurred by excess fat can impair the immune response. Excess fatty tissue can also reduce the amount of vaccine that enters the bloodstream.
- Diabetes: Uncontrolled high blood sugar damages the immune system and makes the body less able to recognize infectious organisms like HBV.
- Chronic kidney disease (CKD): Progressive declines in kidney function can impair the body’s ability to recognize and respond to HBV.
Conclusion
In conclusion, while all hepatitis B vaccines can provide protection from HBV for a lifetime, the type of vaccine used may not be as important as the completion of the recommended series and the individual’s immune response. Nonresponders, who are estimated to make up 5% to 10% of people vaccinated for hepatitis B, may require additional measures to ensure protection.
Frequently Asked Questions
Q: How can I ensure that I complete the recommended hepatitis B vaccine series?
A: Work with your healthcare provider to create a personalized vaccination schedule and stick to it.
Q: What if I am a nonresponder? What are my options?
A: Consult with your healthcare provider to determine the best course of action. This may include additional vaccinations or other forms of protection.
Q: How can I prevent HBV transmission?
A: Practice safe sex, use condoms, and get vaccinated against HBV.
Q: What are the most common ways HBV is transmitted?
A: HBV is primarily spread through blood-to-blood contact, such as through sharing needles or having unprotected sex with an infected partner.
Q: How can I get tested for HBV?
A: Consult with your healthcare provider to determine the best testing schedule for your needs.
Author Bio
James Myhre and Dennis Sifris, MD
Dr. Sifris is an HIV specialist and Medical Director of LifeSense Disease Management. Myhre is a journalist and HIV educator.
