Effectiveness of low‐dose intradermal hepatitis B vaccination: Five years’ experience of primary vaccination

Abstract

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.