Age-specific Seroprotection after Hepatitis B Virus vaccination among Korean American Pediatric Population in Queens, New York

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Background: Hepatitis B Virus (HBV) infection is a major health issue among the Korean American population. 13.4% of Asian Americans residing in NY were diagnosed with chronic HBV infection compared with 0.3% of the overall USA population. Immunization through hepatitis B vaccine is the most effective measure to prevent HBV infection. However, previous study showed that only about half of adolescent vaccinee were anti-HBs positive. The efficacy and long-term immunity of HBV vaccination in Korean American pediatric population were not well explored.  

Objective: (1) To determine the age-specific prevalence of anti-HBs seropositivity through hepatitis B vaccination among Korean American pediatric population living in Queens, NY, and (2) assess biologic and demographic factors influencing immunologic response to hepatitis B vaccine.  

Design/Methods: We performed a retrospective chart review of subjects registered in the pediatric health clinic located in Queens, NY from October 2014 to October 2020. We reviewed 604 medical records of Korean Americans aged 18 years and younger who had completed a full series of HBV vaccine during infancy. Among them, HBV serology test (HBsAg and anti-HBs) results were available in 91 patients. We grouped them into two, HBsAg/anti-HBs (-/+) (n=50) and HBsAg/anti-HBs (-/-) (n=41) and analyzed biologic and demographic data between the groups. 

Results: Overall, 54.9% (50 of 91) of subjects were seropositive. Seropositivity rates in male and female were 50% (29 of 58) and 63.6% (21 of 33) respectively (p=0.27). Seropositive rate in 15~18 year-old-age group (14.3%) was significantly lower than other age groups: < 1 year (100%) (p=0.015), 1~4 (52.6%) (p=0.033), 5~9 (63.3%) (p=0.0034), and 10~14 (64%) (p=0.0063). The mean duration since vaccination in seronegative subjects was significantly longer than that in seropositive subjects (121.7 ± 64.2 months vs 96.5 ± 53.9 months, p<0.047). Foreign birth contributed to a significantly increased risk of non-seroprotective status (p=0.014).

Conclusions: Factors influencing seropositivity rate were 1) age, the duration of time after primary vaccination, and 2) place of birth. Korean American adolescents aged 15~18 years residing in Queens NY who are at high risk of exposure to HBV infection showed lower seropositivity rate. Given the question about duration of immune memory and the necessity of booster vaccination has not been clearly answered, we suggest a routine measurement of anti-HBs titer after 15 years of age and a booster vaccination accordingly in Korean American adolescents. Future studies should examine the potential role for booster vaccinations in a large sample size, multicenter prospective cohort study. 

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SUNY Downstate Medical Center
SUNY Downstate Medical Center/ Herricks High School

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