School of Population and Public Health, Vancouver, British Columbia, Canada.
J Travel Med. 2014 Jul-Aug;21(4):260-5. doi: 10.1111/jtm.12123. Epub 2014 May 5.
Vaccination against hepatitis B virus (HBV) is recommended for all travelers visiting HBV-endemic countries. However, travelers often present with insufficient time for the standard HBV vaccine schedule (SVS). We examined seroprotection against HBV following an alternative two-visit vaccination schedule (TVS) with currently available vaccine products, and completion rates with this TVS.
A retrospective cohort study was conducted in three travel clinics in British Columbia, Canada. Adults ≥20 years old traveling to an HBV-endemic country, and unable to complete the standard or rapid HBV vaccination schedule before departure, were offered a TVS that consisted of a double dose of HBV vaccine at day 0, followed by a single dose in 4 to 12 months. Immunity to HBV [anti-HBV surface antigen (HBs) ≥10 mIU/mL] was determined 1 to 6 months following the final dose of HBV vaccine. Logistic regression modeling was used to assess correlates of seroprotection. We also determined completion rate with this TVS at two clinics.
In total, 117 participants (age range, 21-81 years, median age 57) met the inclusion criteria. Of these, 97 (82.9%) were immune after the TVS. Immunity was demonstrated in 93.1% of patients <50 years old and 79.5% of patients ≥50 years old. Increasing age was associated with reduced odds of developing immunity to HBV using the TVS [adjusted odds ratio = 0.954, 95% confidence interval (CI): 0.904, 1.008]. The completion rate of the TVS was 32.6% over a 12-month period. Completion rates varied between clinics (23.5% vs 48.4%, p < 0.001), suggesting that clinic-specific follow-up policies were important.
Seroprotection with completion of this TVS was similar to or exceeded that published in the literature for the SVS by age. However, even with a TVS, completion rates were low, underscoring the importance of follow-up. Further research is needed to determine whether travelers are protected prior to completion of this TVS.
乙型肝炎病毒（HBV）疫苗接种被推荐给所有前往 HBV 流行国家的旅行者。然而，旅行者通常没有足够的时间按照标准 HBV 疫苗接种计划（SVS）进行接种。我们研究了使用目前可用的疫苗产品进行替代两剂接种方案（TVS）后对 HBV 的血清保护作用，以及该 TVS 的完成率。
在加拿大不列颠哥伦比亚省的三个旅行诊所进行了一项回顾性队列研究。年龄在 20 岁及以上、前往 HBV 流行国家且在出发前无法完成标准或快速 HBV 疫苗接种计划的成年人，被提供了 TVS，即在第 0 天接种双倍剂量的 HBV 疫苗，然后在 4 至 12 个月内接种单剂。在接种最后一剂 HBV 疫苗后 1 至 6 个月，测定对 HBV 的免疫力[抗 HBV 表面抗原（HBs）≥10mIU/mL]。使用逻辑回归模型评估血清保护的相关性。我们还确定了两个诊所中使用该 TVS 的完成率。
共有 117 名符合条件的参与者（年龄 21-81 岁，中位年龄 57 岁）。其中，97 名（82.9%）在 TVS 后具有免疫力。在年龄<50 岁的患者中，有 93.1%的人具有免疫力，在年龄≥50 岁的患者中，有 79.5%的人具有免疫力。使用 TVS 时，年龄越大，对 HBV 产生免疫力的可能性越低[调整后的优势比=0.954，95%置信区间（CI）：0.904，1.008]。在 12 个月的时间内，该 TVS 的完成率为 32.6%。各诊所之间的完成率存在差异（23.5%比 48.4%，p<0.001），表明诊所特定的随访政策很重要。
按照 TVS 完成后，血清保护作用与 SVS 文献报道的结果相似或超过了按年龄划分的结果。然而，即使使用 TVS，完成率仍然较低，这突出了随访的重要性。需要进一步研究以确定旅行者在完成该 TVS 之前是否得到保护。
