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Effectiveness of low-dose intradermal hepatitis B vaccination. Five years' experience of primary vaccination
S C Thompson1, R Darlington, D Tallent
1Health and Community Services, Infectious Diseases Program, Melbourne, Vic.
Objective:
To determine whether intradermal hepatitis B vaccination is an effective procedure.
Design:
A study of antibody responses to hepatitis B vaccine in 753 medical students.
Setting:
Routine vaccination of medical students with intradermal doses of hepatitis B vaccines of various origins.
Outcome Measures:
Rates of seroconversion and geometric mean levels of antibody achieved.
Results:
Seroconversion rates, indicated by antibody to hepatitis B surface antigen (anti-HBs) levels of 10 mIU/mL or more, varied between 82% and 94.7% with different preparations of the vaccine. With a four-dose intradermal schedule over two successive cohorts, Engerix-B (SmithKline Beecham) gave better responses, in this context, than H-B-Vax II (Merck Sharp & Dohme). Any reactions to the vaccination were mild and local.
Conclusion:
The intradermal route is a practical method of vaccination against hepatitis B in healthy young adults when the cost of the vaccine is an inhibiting factor.
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