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Abstract Details
Vitamin D and the Hepatitis B Vaccine Response: A Prospective Cohort Study and a Randomized, Placebo-Controlled Oral Vitamin D 3 and Simulated Sunlight Supplementation Trial in Healthy Adults
Nutr. 2020 May 10.doi: 10.1007/s00394-020-02261-w. Online ahead of print
Daniel S Kashi12, Samuel J Oliver3, Laurel M Wentz4, Ross Roberts1, Alexander T Carswell1, Jonathan C Y Tang5, Sarah Jackson6, Rachel M Izard7, Donald Allan8, Lesley E Rhodes9, William D Fraser5, Julie P Greeves56, Neil P Walsh2
Author information
1College of Human Sciences, Bangor University, Bangor, LL57 2PZ, UK.
2Faculty of Science, Liverpool John Moores University, Liverpool, UK.
3College of Human Sciences, Bangor University, Bangor, LL57 2PZ, UK. s.j.oliver@bangor.ac.uk.
4Beaver College of Health Sciences, Appalachian State University, Boone, USA.
5Norwich Medical School, University of East Anglia, Norwich, UK.
6Department of Army Health and Physical Performance Research, Army HQ, Andover, UK.
7Occupational Medicine, HQ Army Recruiting and Initial Training Command, Upavon, UK.
8Medical Physics Department, Salford Royal NHS Foundation Trust, and University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
9Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Abstract
Purpose: To determine serum 25(OH)D and 1,25(OH)2D relationship with hepatitis B vaccination (study 1). Then, to investigate the effects on hepatitis B vaccination of achieving vitamin D sufficiency (serum 25(OH)D ≥ 50 nmol/L) by a unique comparison of simulated sunlight and oral vitamin D3 supplementation in wintertime (study 2).
Methods: Study 1 involved 447 adults. In study 2, 3 days after the initial hepatitis B vaccination, 119 men received either placebo, simulated sunlight (1.3 × standard-erythema dose, 3 × /week for 4 weeks and then 1 × /week for 8 weeks) or oral vitamin D3 (1000 IU/day for 4 weeks and 400 IU/day for 8 weeks). We measured hepatitis B vaccination efficacy as percentage of responders with anti-hepatitis B surface antigen immunoglobulin G ≥ 10 mIU/mL.
Results: In study 1, vaccine response was poorer in persons with low vitamin D status (25(OH)D ≤ 40 vs 41-71 nmol/L mean difference [95% confidence interval] - 15% [- 26, - 3%]; 1,25(OH)2D ≤ 120 vs ≥ 157 pmol/L - 12% [- 24%, - 1%]). Vaccine response was also poorer in winter than summer (- 18% [- 31%, - 3%]), when serum 25(OH)D and 1,25(OH)2D were at seasonal nadirs, and 81% of persons had serum 25(OH)D < 50 nmol/L. In study 2, vitamin D supplementation strategies were similarly effective in achieving vitamin D sufficiency from the winter vitamin D nadir in almost all (~ 95%); however, the supplementation beginning 3 days after the initial vaccination did not effect the vaccine response (vitamin D vs placebo 4% [- 21%, 14%]).
Conclusion: Low vitamin D status at initial vaccination was associated with poorer hepatitis B vaccine response (study 1); however, vitamin D supplementation commencing 3 days after vaccination (study 2) did not influence the vaccination response.
Clinical trial registry number: Study 1 NCT02416895; https://clinicaltrials.gov/ct2/show/study/NCT02416895; Study 2 NCT03132103; https://clinicaltrials.gov/ct2/show/NCT03132103.