As a result, antibodies for some vaccine-preventable diseases should be measured regularly to ensure that these patients receive booster doses as soon as the antibody levels begin to wane, according to the researchers from Paris Descartes University and Pierre and Marie Curie University in Paris.
“Recommendations on the timing of booster injections were based on data collected in healthy persons, although antibody decay patterns may be different,” the researchers wrote in Clinical Infectious Diseases. “In this respect, an important question is to estimate, among patients who initially responded to immunization, how seroprotection decreases over time.”
The researchers conducted a systematic review of 54 studies that included data on 13 vaccines: Streptococcus pneumoniae, hepatitis B, measles,hepatitis A, tetanus, yellow fever, Haemophilus influenzae type b, rubella, varicella, pertussis, poliovirus, mumps and Japanese encephalitis. Nineteen of the studies were included in the meta-analysis.
For hepatitis B, the researchers recommend measuring HBV antibodies yearly in adults and every 2 to 5 years in children at risk. Those at risk for hepatitis A from traveling, drug use or other risks should have hepatitis A virus antibodies measured every 5 years because nearly 20% of primary responders lost their seroprotection by this time. Tetanus boosters are recommended every 10 years.
Children with HIV and an undetectable viral load should receive two doses of measles vaccine after starting antiretroviral therapy. Those who were vaccinated before ART or who have a detectable HIV viral load are eligible for a third dose 2 to 5 years after primary vaccination. For the yellow fever vaccine, patients with potential exposure to the disease should have the antibody titers measured and be re-vaccinated if there are negative titers.
No recommendations were made regarding the pneumococcal vaccine or strategies of combining the two pneumococcal vaccines because the data available on this topic are preliminary, according to the researchers.
“Clinical implications of this work need to be further explored on large prospective cohorts,” the researchers wrote. “In the future, the evaluation of new vaccines that specifically target persons with impaired immunity should confront clinical effectiveness with precise evaluation of both humoral and cellular responses, in an attempt to establish reliable correlates of protection in these populations.”