{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T19:59:34Z","timestamp":1776455974523,"version":"3.51.2"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T00:00:00Z","timestamp":1677801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: The Hepatitis B virus (HBV) vaccine is used worldwide as an efficient tool to prevent the occurrence of chronic HBV infection and the subsequent liver disease. However, despite decades of vaccination campaigns, millions of new infections are still reported every year. Here, we aimed to assess the nationwide HBV vaccination coverage in Mauritania as well as the presence of protective levels of the antibodies against HBV surface antigen (HBsAb) following vaccination in a sample of children immunized as infants. Methods: To evaluate the frequency of fully vaccinated and seroprotected children in Mauritania, a prospective serological study was conducted in the capital. First, we evaluated the pediatric HBV vaccine coverage in Mauritania between 2015 and 2020. Then, we examined the level of antibodies against HBV surface antigen (HBsAb) in 185 fully vaccinated children (aged 9 months to 12 years) by ELISA using the VIDAS hepatitis panel for Minividas (Biomerieux). These vaccinated children were sampled in 2014 or 2021. Results: In Mauritania, between 2016 and 2019, more than 85% of children received the complete HBV vaccine regimen. While 93% of immunized children between 0 and 23 months displayed HBsAb titer &gt;10 IU\/L, the frequency of children with similar titers decreased to 63, 58 and 29% in children aged between 24\u201347, 48\u201359 and 60\u2013144 months, respectively. Conclusions: A marked reduction in the frequency of HBsAb titer was observed with time, indicating that HBsAb titer usefulness as marker of protection is short lived and prompting the need for more accurate biomarkers predictive of long-term protection.<\/jats:p>","DOI":"10.3390\/vaccines11030588","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T04:29:58Z","timestamp":1678076998000},"page":"588","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The First Assessments of Pediatric HBV Immunization Coverage in Mauritania and Persistence of Antibody Titers Post Infant Immunizations"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8331-9591","authenticated-orcid":false,"given":"Hala","family":"El Hachimi","sequence":"first","affiliation":[{"name":"Unit of Epidemiology Molecular and Diversity of Microorganisms, University of Nouakchott, Nouakchott 2373, Mauritania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9660-1457","authenticated-orcid":false,"given":"Mohamed Mahmoud Mohamed","family":"El Alem","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology Molecular and Diversity of Microorganisms, University of Nouakchott, Nouakchott 2373, Mauritania"},{"name":"National Reference Laboratory of Leishmaniasis, National Institute of Hygiene, Rabat 10010, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esma","family":"Haimoudane","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology Molecular and Diversity of Microorganisms, University of Nouakchott, Nouakchott 2373, Mauritania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3282-4891","authenticated-orcid":false,"given":"Cheikh","family":"Yebouk","sequence":"additional","affiliation":[{"name":"Laboratoire National de Contr\u00f4le de la Qualit\u00e9 des M\u00e9dicaments, Nouakchott 5347, Mauritania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jannie","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Global Urgent and Advanced Research and Development, Batiscan, QC G0X 1A0, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F-Zahra","family":"Fall-Malick","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology Molecular and Diversity of Microorganisms, University of Nouakchott, Nouakchott 2373, Mauritania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatimetou","family":"Khiddi","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology Molecular and Diversity of Microorganisms, University of Nouakchott, Nouakchott 2373, Mauritania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9774-4795","authenticated-orcid":false,"given":"Mohamed","family":"Abdawe","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology Molecular and Diversity of Microorganisms, University of Nouakchott, Nouakchott 2373, Mauritania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidi Ahmed","family":"Sadegh","sequence":"additional","affiliation":[{"name":"Unit of Research: Marine Ecobiology, Environment, Health and Nutrition EBIOMESN, University of Nouakchott, Nouakchot 2373, Mauritania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugues","family":"Fausther-Bovendo","sequence":"additional","affiliation":[{"name":"Global Urgent and Advanced Research and Development, Batiscan, QC G0X 1A0, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Vall","family":"Mohamed Abdellahi","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology Molecular and Diversity of Microorganisms, University of Nouakchott, Nouakchott 2373, Mauritania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.14312\/2053-1273.2013-2","article-title":"Routine immunization services in Africa: Back to basics","volume":"1","author":"Nshimirimana","year":"2013","journal-title":"J. Vaccines Immun."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2132","DOI":"10.1080\/21645515.2015.1044180","article-title":"The value of childhood combination vaccines: From beliefs to evidence","volume":"11","author":"Maman","year":"2015","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1128\/IAI.74.5.2619-2627.2006","article-title":"Maternal immunity provides protection against pertussis in newborn piglets","volume":"74","author":"Elahi","year":"2006","journal-title":"Infect. Immun."},{"key":"ref_4","unstructured":"World Health Organization (2015). Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection, WHO."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/S2468-1253(19)30042-1","article-title":"Hepatitis B Virus Infection in Children and Adolescents","volume":"4","author":"Indolfi","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Mitchell, T., Armstrong, G.L., Hu, D., Wasley, A., and Painter, J.A. (2011). The Increasing Burden of Imported Chronic Hepatitis B\u2014United States, 1974\u20132008. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0027717"},{"key":"ref_7","unstructured":"World Health Organization, and Regional Office for the Western Pacific (2017). Expert Consultation on Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B and Syphilis in the Western Pacific, Manila, Philippines, 20\u201321 February 2017, WHO Regional Office for the Western Pacific. Available online: http:\/\/iris.wpro.who.int\/handle\/10665.1\/1359415."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"World Health Organization (2019). Hepatitis B vaccines: WHO position paper, July 2017\u2014Recommendations. Vaccine, 37, 223\u2013225.","DOI":"10.1016\/j.vaccine.2017.07.046"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1177\/0956462413476274","article-title":"Seroprevalence of hepatitis B in a cohort of HIV-infected children and adults in Swaziland","volume":"24","author":"Dziuban","year":"2013","journal-title":"Int. J. STD AIDS"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3923\/jpt.2016.27.32","article-title":"Long Term Immunity to Hepatitis B Vaccine Among a Sample of Secondary School Students in Damietta","volume":"11","author":"Mazahi","year":"2015","journal-title":"J. Pharmacol. Toxicol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S2468-1253(18)30056-6","article-title":"Global Prevalence, Treatment, and Prevention of Hepatitis B Virus Infection in 2016: A Modelling Study","volume":"3","author":"Gamkrelidze","year":"2018","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"461","DOI":"10.3345\/kjp.2016.59.12.461","article-title":"Recommended immunization schedule for children and adolescents: Immunization Guideline (8th edition) released by the Korean Pediatric Society in 2015","volume":"59","author":"Kim","year":"2016","journal-title":"Korean J. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/S1473-3099(15)00158-9","article-title":"Global elimination of mother-to-child transmission of hepatitis B: Revisiting the current strategy","volume":"15","author":"Thio","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"711","DOI":"10.2169\/internalmedicine.54.3514","article-title":"Factors Associated with Mother-to-child Transmission of Hepatitis B Virus Despite Immunoprophylaxis","volume":"54","author":"Liu","year":"2015","journal-title":"Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3943","DOI":"10.1016\/j.vaccine.2013.06.039","article-title":"Factors associated with vaccination for hepatitis B, pertussis, seasonal and pandemic influenza among French general practitioners: A 2010 survey","volume":"31","author":"Pulcini","year":"2013","journal-title":"Vaccine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/j.vaccine.2010.11.060","article-title":"Long-term antibody persistence and immune memory to hepatitis B virus in adult celiac patients vaccinated as adolescents","volume":"29","author":"Zingone","year":"2011","journal-title":"Vaccine"},{"key":"ref_17","unstructured":"(2022, October 23). Prevention of Mother-to-Child Transmission of Hepatitis B Virus: Guidelines on Antiviral Prophylaxis in Pregnancy. Available online: https:\/\/www.who.int\/publications-detail-redirect\/978-92-4-000270-8."},{"key":"ref_18","unstructured":"World Health Organization (2022, May 15). GHO | By Category | Hepatitis B (HepB3)\u2014Immunization Coverage Estimates by Country. Available online: https:\/\/apps.who.int\/gho\/data\/view.main.80300."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"7","DOI":"10.4236\/wjv.2021.112002","article-title":"Seroconversion of Hepatitis B Vaccine in Young Bangladeshi Children: A Tertiary Centre Experience","volume":"11","author":"Mahmud","year":"2021","journal-title":"World J. Vaccines"},{"key":"ref_20","first-page":"1557","article-title":"Hepatitis B Seroconversion after Vaccination in Infants in Rural and Urban Areas of Rawalpindi, Pakistan","volume":"5","author":"Perveen","year":"2015","journal-title":"J. Adv. Med. Med. Res."},{"key":"ref_21","unstructured":"(2022, June 05). Available online: https:\/\/pdf.usaid.gov\/pdf_docs\/PA00Z537.pdf."},{"key":"ref_22","first-page":"247","article-title":"Hepatitis B virus infection in the school milieu of Kiffa and Selibaby, Mauritania","volume":"91","author":"Rui","year":"1998","journal-title":"Bull. Soc. Pathol. Exot."},{"key":"ref_23","first-page":"140","article-title":"Hepatitis B virus (HBV) infection amongst children in Senegal: Current prevalence and seroprotection level","volume":"32","author":"Babacar","year":"2019","journal-title":"Pan. Afr. Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.jhep.2009.01.002","article-title":"Hepatitis B vaccination: The key towards elimination and eradication of hepatitis B","volume":"50","author":"Chen","year":"2009","journal-title":"J. Hepatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"189","DOI":"10.4269\/ajtmh.2010.09-0589","article-title":"Serologic and Molecular Characteristics of Hepatitis B Virus among School Children in East Java, Indonesia","volume":"83","author":"Utsumi","year":"2010","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1111\/jvh.13589","article-title":"Sibling status, home birth, tattoos and stitches are risk factors for chronic hepatitis B virus infection in Senegalese children: A cross-sectional survey","volume":"28","author":"Protopopescu","year":"2021","journal-title":"J. Viral. Hepat."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e00516","DOI":"10.1002\/hsr2.516","article-title":"Impact of COVID-19 pandemic on routine vaccination coverage of children and adolescents: A systematic review","volume":"5","author":"Karimi","year":"2022","journal-title":"Health Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"12550","DOI":"10.1038\/s41598-018-30512-8","article-title":"Immune Persistence After Infant Hepatitis-B Vaccination: A Systematic Review and Meta-Analysis","volume":"8","author":"Mahmood","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"103","DOI":"10.3329\/bmrcb.v44i2.38705","article-title":"Immune response among the children to hepatitis B vaccination: A community-based study in Bangladesh","volume":"44","author":"Hossain","year":"2018","journal-title":"Bangladesh Med. Res. Counc. Bull."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/S0264-410X(01)00493-5","article-title":"Immunogenicity of Hepatitis B vaccine in preterm and full term infants vaccinated within the first week of life","volume":"20","author":"Jorge","year":"2002","journal-title":"Vaccine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"6","DOI":"10.4038\/cmj.v47i1.6396","article-title":"Seroconversion after hepatitis B vaccination in healthy young adults, and the effect of a booster dose","volume":"47","author":"Perera","year":"2014","journal-title":"Ceylon Med. J."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Dassah, S., Sakyi, S.A., Frempong, M.T., Luuse, A.T., Ephraim, R.K., Anto, E.O., and Oduro, A. (2015). Seroconversion of hepatitis B vaccine in young children in the Kassena Nankana district of Ghana: A cross-sectional study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0145209"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.3855\/jidc.10433","article-title":"Hepatitis B vaccination in Burkina Faso: Prevalence of HBsAg carriage and immune response in children in the western region","volume":"12","author":"Sanou","year":"2018","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Lee, K.H., Shim, K.S., Lim, I.S., Chae, S.A., Yun, S.W., Lee, N.M., Choi, Y.B., and Yi, D.Y. (2017). Changes in hepatitis B virus antibody titers over time among children: A single center study from 2012 to 2015 in an urban of South Korea. BMC Pediatr., 17.","DOI":"10.1186\/s12887-017-0924-7"},{"key":"ref_35","first-page":"2131627","article-title":"Assessment of Immunization to Hepatitis B Vaccine among Children under Five Years in Rural Areas of Taiz, Yemen","volume":"2017","author":"Alssamei","year":"2017","journal-title":"Hepat. Res. Treat."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1111\/jvh.12818","article-title":"Changes and analysis of anti-HBs titres after primary immunization in 1- to 16-year-old Chinese children: A hospital-based study","volume":"25","author":"Yue","year":"2018","journal-title":"J. Viral Hepat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1080\/21645515.2015.1041687","article-title":"Age-dependent decrease of anti-HBs titers and effect of booster doses using 2 different vaccines in Palestinian children vaccinated in early childhood","volume":"11","author":"Qawasmi","year":"2015","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3889\/oamjms.2016.043","article-title":"Hepatitis B Seroprotection and the Response to a Challenging Dose among Vaccinated Children in Red Sea Governorate","volume":"4","author":"Sami","year":"2016","journal-title":"Open Access Maced. J. Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1093\/cid\/cir270","article-title":"Hepatitis B and the Need for a Booster Dose","volume":"53","author":"Leuridan","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/infdis\/jiv748","article-title":"Antibody levels and protection after hepatitis B vaccine: Results of a 30-year follow-up study and response to a booster dose","volume":"214","author":"Bruce","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Qu, C., Chen, T., Fan, C., Zhan, Q., Wang, Y., Lu, J., Lu, L.-L., Ni, Z., Huang, F., and Yao, H. (2014). Efficacy of neonatal HBV vaccination on liver cancer and other liver diseases over 30-year follow-up of the Qidong hepatitis B intervention study: A cluster randomized controlled trial. PLoS Med., 11.","DOI":"10.1371\/journal.pmed.1001774"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1016\/j.jhep.2013.08.021","article-title":"Long-term protection of neonatal hepatitis B vaccination in a 30-year cohort in Hong Kong","volume":"59","author":"Lin","year":"2013","journal-title":"J. Hepatol."},{"key":"ref_43","first-page":"369","article-title":"HBV vaccination and HBV infection induces HBV-specific natural killer cell memory","volume":"70","author":"Wijaya","year":"2021","journal-title":"Gut"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1080\/14760584.2021.1908133","article-title":"CpG-Adjuvanted Hepatitis B Vaccine (HEPLISAV-B\u00ae) Update","volume":"20","author":"Lee","year":"2021","journal-title":"Expert Rev. Vaccines"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1084\/jem.20051720","article-title":"Yellow Fever Vaccine YF-17D Activates Multiple Dendritic Cell Subsets via TLR2, 7, 8, and 9 to Stimulate Polyvalent Immunity","volume":"203","author":"Querec","year":"2006","journal-title":"J. Exp. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2037384","DOI":"10.1080\/21645515.2022.2037384","article-title":"Longevity of Immunity Following COVID-19 Vaccination: A Comprehensive Review of the Currently Approved Vaccines","volume":"18","author":"Jamshidi","year":"2022","journal-title":"Hum. Vaccines Immunother."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/3\/588\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:47:33Z","timestamp":1760122053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/11\/3\/588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,3]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["vaccines11030588"],"URL":"https:\/\/doi.org\/10.3390\/vaccines11030588","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,3]]}}}