New Advances in Hepatitis B Vaccination for Adults
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Purpose of Review
The mainstay of elimination of hepatitis B virus is through primary prevention by vaccination recommended by the World Health Organization. This review seeks to update readers on the performance of the current second-generation vaccine and the challenges including primary and secondary vaccine failure, as well as compliance and coverage.
Primary vaccine failure in children may be overcome by HBIG and antiviral therapy in high-risk pregnancies, while in adults, a number of strategies to address this include intradermal delivery, double-dose vaccination, improved adjuvants, and a third-generation vaccine with pre-S1 and pre-S2 proteins. However, there is still no accepted standard therapy for primary vaccine failure. Secondary vaccine failure is less problematic with 3.9% of vaccines developing anti-HBc antibody, but only one reported case of chronicity has developed after vaccination.
The current second-generation prophylactic hepatitis B vaccines have performed extremely well, but there remain some challenges with regard to vaccine failure. A number of different strategies have been used to overcome this. Overall vaccine failure constitutes a relatively small proportion of vaccinees.
KeywordsHepatitis B vaccine Primary vaccine failure Secondary vaccine failure Vaccine non-compliance Pre-S1 Pre-S2 Adjuvants
Compliance with Ethical Standards
Conflict of Interest
Seng-Gee Lim reports grants, personal fees, and non-financial support from Gilead Sciences; personal fees from Abbvie; grants and personal fees from Abbott Diagnostics; grants and personal fees from Merck; grants and personal fees from Roche; and personal fees from Springbank outside the submitted work. Qingyao Daniel Huang declares no potential conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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