Improving Hepatitis B Virus Vaccination Responses in Inflammatory Bowel Disease: Does Greater Dose and Greater Frequency Lead to Greater Protection?

Prevention of hepatitis B (HBV) infection is particularly important for patients with inflammatory bowel disease because of risks of HBV reactivation on immunosuppressive therapies. However, immune responses to standard HBV vaccination regimens are suboptimal. Chaparro et al. compared immune responses to 2 vaccines, an adjuvanted HBV vaccine (Fendrix) and double-dosed standard vaccine (Engerix-B) using an accelerated, 4-dose regimen (0, 1, 2, and 6 months). Although the study did not demonstrate superiority of one vaccine over another, several lessons can be derived regarding immune response to vaccinations among patients with inflammatory bowel disease, including the need to consider nonstandard regimens for patients on immunosuppression. These lessons can be translated broadly, including to a potential future severe acute respiratory syndrome coronavirus 2 vaccine when one becomes available.