Evaluating the Influence of Maternal Anti-HBs Status on the Antibody Levels in Vaccinated Children - 30/04/25

Doi : 10.1016/j.clinre.2025.102608

Naim Abu-Freha ^a,^c,^⁎ , Safa Shibli ^d, Ohad Etzion ^b,^c, Yaser Afianish ^b, Johnny Amer ^d, Heba Abu Kaf ^b, Nachum Zohar ^e, David Yardeni ^b,^c, Rifaat Safadi ^d
^a Institute of Gastroenterology and Hepatology, Clalit, Southern Districit, Beer-Sheva, Israel
^b Institute of Gastroenterology and Hepatology, Soroka University Medical Center, Beer-Sheva, Israel
^c Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
^d Department of Medicine, Liver Institute, Hebrew University, Hadassah Medical Organization, Jerusalem, Israel
^e Maternal and Fetal Medicine Service, Obstetrics & Gynecology, Emek Medical Center, Afula, Israel

^⁎Corresponding author. Naim Abu-Freha, Institute of Gastroenterology and Hepatology, Soroka University Medical Center.P.O. Box 151, Beer-Sheva 84101, Israel, Tel. +972-8-640-2251, Fax: +972-8-623-3083Institute of Gastroenterology and HepatologySoroka University Medical Center.P.O. Box 151Beer-Sheva84101Israel

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Highlights

•	No significant difference in anti-HBs positivity rates between children of vaccinated (70.4%) and unvaccinated mother..(69.7%).
•	While vaccine response rates declined with age, they remained similar for children of both vaccinated and unvaccinated mothers.
•	Children of mothers with low or negative anti-HBs antibody levels had a higher proportion of strong antibody responses (≥1001 mlU/ml) in infancy.

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Abstract

Background and Aims: The mother's Hepatitis B Virus (HBV) vaccination status may impact the child's response. We aimed to investigate the children's vaccine response based on the mother's vaccination status. Methods: In a retrospective study, we included children ≤10 years old born to HBsAg negative mothers, with available maternal and children anti-HBs antibodies. Children of vaccinated and unvaccinated mothers were compared and categorized based on anti-HBs titers: 0-9.9, 10-100, 101-500, 501-1000, and ≥1001 mlU/ml. Results: 14,485 children were included. No significant difference in the anti-HBs positivity rate was found among the children of vaccinated and unvaccinated mothers (70.4% vs. 69.7%, p=0.337). Vaccine response in vaccinated vs. unvaccinated mothers was 93.5% vs. 92.1% for the first year of age, 87.7% vs. 87.3% for age 3 years, and 82.5% vs. 82.2% for age 5 years, respectively. Young children (7-36 months) had higher protective titer rates than older children. A higher proportion of the ≥1001 mlU/ml category was recorded among children of mothers with negative or low anti-HBs antibodies in the first year of age, reaching 40.9%. With age, the proportion of children with 10-100 mlU/ml increased, corresponding to the mother's titer. Conclusion: The maternal HBV vaccination status does not impact the children's response, but the mother's anti-HBs titers may affect the child's antibody level. Maternal anti-HBs antibody titers may neutralize the vaccine HBsAg to impair the reponse.

•	No additional data are available
•	The study was not funded
•	There are no conflicts of interest for any authors and no financial disclosures.
•	The local Helsinki Committee approved the study
•	Informed consent was waived due to the retrospective design of the study.
•	All authors have contributed significantly to the work and have approved the final version of the manuscript.
•	The manuscript has not been published and is not being considered for publication elsewhere.
•	We transfer the copyright should the article be published.