Vaccine
http://www.sciencedirect.com/science/journal/0264410X
Volume 30, Issue 21 pp. 3147-3248 (2 May 2012)

Brief Report
Hepatitis B vaccination of susceptible elderly residents of long term care facilities during a hepatitis B outbreak
Pages 3147-3150
Roxanne E. Williams, Arlene C. Sena, Anne C. Moorman, Zack S. Moore, Umid M. Sharapov, Jan Drobenuic, Dale J. Hu, Hattie W. Wood, Jian Xing, Philip R. Spradling

Abstract
Protection of older persons, particularly those with diabetes, against hepatitis B virus (HBV) infection is of growing concern because of increased reports of outbreaks among long-term care facility residents receiving assisted blood glucose monitoring. We evaluated hepatitis B vaccine immunogenicity among residents immunized in response to two such outbreaks in skilled nursing facilities during June 2009–July 2010. One hundred forty-eight (71%) of 209 residents were found to be susceptible to HBV infection. Of 105 patients who began a vaccination series with Twinrix® (0-, 1-, 6-month dosing), 86 (82%) completed the series and postvaccination testing. Of these, most were elderly (median age 79.5 years; range 45–101), female (56%), and African-American (51%). Twenty-nine (34%) vaccinated residents had post-vaccination hepatitis B surface antibody levels ≥10 mIU/ml. There were no significant differences in vaccine response by age, gender, race, diabetes status, body mass index, or current smoking status. Our findings indicate that a low proportion of skilled nursing facility residents achieved a seroprotective response after hepatitis B vaccination.