Hepatitis B vaccination strategy in vaccine low and non-responders: A matter of quantity of quality?

Hepatitis B virus infection can lead to chronic infection and liver failure. Transmission of the virus is preventable though vaccination. Unfortunately, 5-10% of healthy individuals and 40-50% of haemodialysis patients do not develop an adequate immune response against the vaccine. In this commentary we focus on the possible biological mechanisms of hepatitis B vaccine unresponsiveness, and give practical advice to overcome this unresponsiveness.