The authors wrote, “Universal vaccination programs have significantly reduced the rate of HBV transmission; however, a subset of individuals fail to develop a protective immune response following vaccination and are termed nonresponders.”
To assess the factors that impact vaccine nonresponse, the researchers utilized a comprehensive literature search examining information from PubMed, Google Scholar, and Web of Science databases to find relevant studies employing key terms such as “hepatitis B vaccine,” “vaccine nonresponse,” “immunogenicity,” “immune response to the hepatitis B vaccine,” and “associated risk factors.”
The results revealed that factors impacting vaccine response include demographic characteristics including age and gender, with reports of older adults and males being more prone to experience nonresponse. Additionally, lifestyle factors, including obesity, smoking, and alcohol consumption, can diminish vaccine response, and chronic comorbidities (e.g., diabetes, chronic kidney disease, liver disease, HIV, celiac disease, and inflammatory bowel disease) can affect vaccine response. Major histocompatibility complex haplotypes and genetic polymorphisms correlated with immune regulation are genetic factors that further impact the effectiveness of vaccines.
The authors wrote, “Understanding the mechanisms of waning immunity can inform guidelines for booster vaccinations and long-term hepatitis B prevention strategies. Integrating hepatitis B vaccination efforts into broader public health initiatives can improve the overall vaccine uptake and effectiveness.”
Approaches such as routine adult vaccination programs, particularly for high-risk groups, and augmented public awareness campaigns on the significance of HBV vaccination, HBV infection risk, and adherence to vaccination schedules, are also vital.
The authors concluded that a multifaceted approach is needed to address the global health threat of HBV infection, which necessitates understanding and addressing factors contributing to the nonresponse of the HBV vaccine in some individuals. This multifaceted approach involves addressing vaccine hesitancy, expanding public awareness, and employing genetic testing for individualized vaccination protocols. Moreover, additional strategies include utilizing vaccines with enhanced immunogenicity, revaccinating or increasing the dose, enhancing adjuvants, employing different vaccination routes, and coadministering the vaccine with specific drugs.
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