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J Travel Med. 2013 Sep-Oct;20(5):278-82. doi: 10.1111/jtm.12050. Epub 2013 Jul 9.

Seroprotection after hepatitis a vaccination in patients with drug-induced immunosuppression.

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1
Department of Infectious Diseases, Public Health Service (GGD) Gelre-IJssel, Apeldoorn, The Netherlands.

Abstract

BACKGROUND:

Increasing numbers of travelers using immunosuppressive drugs visit hepatitis A endemic countries. Data on protection rates after hepatitis A vaccination in this group are scarce.

METHODS:

In this retrospective study, records of subjects with hepatitis A serology taken after vaccination were searched for in travel clinic databases. Relation between immunosuppressive drug use, age, gender, and time between vaccination and serology was evaluated.

RESULTS:

Seroprotection rates within 4 weeks after primary vaccination (50%) are lower than after 4 weeks (64%). After the complete series of two vaccinations seroprotection rates reach 95% although success depends on the immunosuppressive drug being used. Subjects under anti-TNF alpha treatment have significantly lower seroprotection rates than subjects using classical immunosuppressive drugs after the second vaccination. There is no influence of age or gender on seroprotection rates.

CONCLUSIONS:

Last-minute vaccination in subjects using immunosuppressive medication is not reliable, only 60% of our subjects had a protective antibody level after a single vaccination. When serology was done within 4 weeks after a single vaccination, seroprotection rates were only 50%, after 4 weeks this number rose to 64%. When persons visit a travel clinic in time for a complete vaccination series, satisfactory seroprotection rates can be reached. Seroprotection rate depends on the drug being used, persons using anti-TNF alpha are less protected.

PMID:
23992569
DOI:
10.1111/jtm.12050
[Indexed for MEDLINE]
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