Immune response of hospital workers to hepatitis B vaccine

Hepatitis B vaccine (Heptavax-B vaccine, Merck Sharp and Dohme) was given by injection into the buttock of 109 healthy workers in a community hospital according to the schedule of the U.S.A. Centers for Disease Control. In only 26% of those between 41 and 65 years of age was antibody to hepatitis B surface antigen found after the full course of vaccination whereas 74% of those aged 18-40 years had detectable antibody. We did not find any significant difference between the responses of males and females in either age group. The unusually poor response may be related to injections being given into the buttock rather than the deltoid region of the arm. We, therefore, recommend that injections of hepatitis B vaccine should be given into the deltoid muscle and that vaccinees should be tested after vaccination for evidence of immunity.