Currently, hepatitis B vaccine is widely used to prevent HBV infection in China and abroad. The Advisory Committee on Immunization Practices (ACIP) proposed that non-immune adults should be encouraged to be immunized with the hepatitis B vaccine (Goldstein et al., 2005
). An American report in 2007 showed that the highest proportion of new hepatitis B infections occurs in the 25 to 44 years old age group (Daniels et al., 2009
). Vaccination for high-risk adults had already begun in USA in 1998 (Mast et al., 1998
), and in 2006, adult hepatitis B vaccination was brought into the system of community primary health care and rehabilitation clinics (Mast et al., 2006
). There were also immunization programs for high-risk adults in Britain and Italy (Bonanni, 1995
; Zuckerman and Langer, 2005
). The usual adult hepatitis B vaccine dose in China is 10 μg. There are three main types of hepatitis B vaccine in China: one is made by recombinant deoxyribonucleic acid (DNA) techniques in Hansenula polymorpha
yeast, one is made by recombinant DNA techniques in CHO cells, and one is a recombinant hepatitis B vaccine (Saccharomyces cerevisiae
). We chose all three for our research, as together they account for more than 90% of adult vaccinations. The results of this study indicated that high anti-HBs seroconversion rates and GMT were observed in adults who received the 10 μg immunization dose. It was also shown that good protective effects can be obtained using the 10 μg dose of the hepatitis B vaccine in China (Gong and Zhong, 2009
; Yao and Chen, 2009
The seroconversion rates of the different hepatitis B vaccine types indicated that the average anti-HBs seroconversion rate was 89.92% after vaccination with the three types of domestic 10 μg hepatitis B vaccines. This was not significantly different from that of the compared group whose anti-HBs seroconversion rate was 86.81%, which indicates that the immune effects of the different types of hepatitis B vaccines were consistent. These results are similar to those of Gong and Zhong (2009
), Zhang et al. (2010
), and others (Bryan et al., 1995
; Rendi-Wagner et al., 2001
). Gong and Zhong (2009
) used 10 μg of hepatitis B vaccine made by recombinant DNA techniques in Saccharomyces cerevisiae
yeast by the Beijing Tiantan Company. The seroconversion rate was 90.69%. They selected 873 HBsAg negative subjects.
Another study of 321 subjects, using 10 μg hepatitis B vaccine produced by the North China Pharmaceutical GeneTech Biotechnology Pharmaceutical Co., Ltd.) (CHO), had an 88.8% seroconversion rate. Factors such as smoking, drinking, and obesity were reportedly associated with immune failure, in addition to a strenuous job, stressful lifestyle, and mental pressure, which may overload the body and lead to a decline in immune function and thereby affect the seroconversion rate. The immune effect of the Dalian High-Tech 10 μg Hansenula hepatitis B vaccine was the best of the four types. Its seroconversion rate reached 95.05%, a rate significantly higher than those of the other three groups. This seroconversion rate was also similar to that of the 20 μg hepatitis B vaccine reported by Young et al. (2001
). This similarity might be caused by the high purity of the Hansenula hepatitis B vaccine, which uses a chemosynthesis complete medium only, and not a selective medium, peptone or yeast powder. The seroconversion rates of the 10 μg hepatitis B vaccine produced by the North China Pharmaceutical Company and GlaxoSmithKline were slightly higher than that of the 10 μg hepatitis B vaccine previously reported by Young et al. (2001
). Regarding the anti-HBs GMT, the immune effects for all the vaccines were good, except those of the Shenzhen Kangtai vaccine. These results suggest that the immune effects of the four hepatitis B vaccine types were good, and that they could provide good protection for the population. Considering the high anti-HBs seroconversion rate and GMT produced by the Dalian High-Tech vaccine, and considering that the persistence of immune protection would be extended as a result of the high GMT peak value (Jilg et al., 1988
; Trivello et al., 1995
; Yuan et al., 2003
), we recommend the Dalian High-Tech vaccine.
An analysis of the hepatitis B vaccine immune effects in adults of different age groups was conducted. After dividing the subjects into five age groups, the relationship between the positive hepatitis B vaccine seroconversion rates and the subjects’ ages was analyzed. The results showed that there was no significant difference in the positive seroconversion rate for 10 μg hepatitis B vaccines among different adult age groups (χ
=0.073). The chi-square trend test also showed a significant decrease in the anti-HBs positive rate with increasing age (χ
=0.026). The positive anti-HBs seroconversion rates were different between the 10 μg hepatitis B vaccine produced by the North China Pharmaceutical Company and that produced by GlaxoSmithKline in the different vaccination age groups. There was a negative correlation (using the chi-square trend test) between the 10 μg hepatitis B vaccine produced by the North China Pharmaceutical Company and the subject’s age. These results indicate that the anti-HBs level attained after vaccination with hepatitis B vaccine was related to age, which was consistent with previous studies (Coates et al., 2001
; Gilbert et al., 2011
). There were no significant differences in the anti-HBs GMT among the three domestic vaccines but compared with the foreign vaccine, a significant difference was found (F
=0.001). Overall, the study shows that vaccination of adults of different ages can result in good immune effects. The results of these studies provide good data in support of expanding immunization programs to adults.
After a long development, domestic hepatitis B vaccines have achieved some advantages, including a lower price compared to other hepatitis B vaccines. In our study, we selected three kinds of domestic vaccine and one foreign vaccine, and evaluated the immune effects of the four vaccines at the same time in a large-scale population. The results of this study confirm that there is little difference in the immune effects between the domestic hepatitis B vaccines (10 μg/dose) and the hepatitis B vaccine (10 μg) produced by GlaxoSmithKline. The immune effect of the hepatitis B vaccine produced by Dalian High-Tech was better than that of the hepatitis B vaccine produced by GlaxoSmithKline. Thus, the evidence supports the widespread use of domestic hepatitis B vaccine (Dong et al., 2009
). The subjects involved in this study will be followed up closely, after one, three, and even five years. We believe this will provide useful scientific data of significance to China’s hepatitis B prevention and control programs.