The long-term effectiveness of hepatitis B vaccination was determined in a
high-risk group of 105 institutionalized mentally retarded. All individuals
were vaccinated in 1986, with three (0, I, 6 months), four (0, 1, 6 and 13
months) or more doses according to their immune response at month 7, resul
ting in group 1 (G1), group 2 (G2) and group 3 (G3). They were annually fol
lowed up for five years, after which they received a booster dose. Eleven y
ears after the initial vaccination, they were again tested for the presence
of hepatitis B virus (HBV) serologic markers. The decline in anti-HBs logt
itre over the first five years was 51% for G1 and 45% for G2. From the boos
ter on month 60 to year Il, the overall decline was 31%. Eleven years after
the start of vaccination and six years after the booster, 92% of the indiv
iduals had protective antibody levels higher than 10 IU/L. G1 had a geometr
ic mean titre of 2015 IU/L, For G3 this was 245 IU/L. The difference in res
ponse to vaccination between the groups did not affect their protection. On
ly two vaccinees seroconverted to anti-HBc positivity without becoming carr
ier or ill. Long-term protection against HBV by vaccination appears to be e
xcellent. (C) 1999 Elsevier Science Ltd. All rights reserved.