title: Low-cost hepatitis B vaccine improves uptake among self-paying health-care students.
abstract: Advisory committees recommend hepatitis B (HBV) immunization for professional and student health-care workers. However, the currently licensed vaccines are expensive, and previous surveys have shown that few students (14%) have been immunized in Canada. A low-cost immunization program was offered to health-care students in order to determine whether the effectiveness of HBV immunization could be improved by substantially reducing the vaccine cost to recipients. The immunogenicity, side effects, and 3-dose completion rate of a low-cost Korean HBV vaccine were compared with a similar U.S.-made vaccine. A total of 922 postsecondary students enrolled in 6 health-care disciplines in Ottawa, Canada were surveyed for hepatitis-B immunization status. Nonimmunized students were subsequently offered HBV vaccine at total cost of $15 (Canadian), randomly allocated to receive 3 intramuscular doses of either Korean or U.S.-made plasma-derived HBV vaccine in a double-blind fashion, surveyed about side effects, and tested for hepatitis B surface antibody seroconversion. Only 12% of the 922 surveyed students had been previously immunized when vaccine was obtainable only at high cost. However, 66% of those not immunized participated in the vaccine trial and paid the $15 fee. Hepatitis-B surface antibody seroconversion (greater than or equal to 10 sample ratio units by radioimmunoassay) occurred in 291/311 (93.6%) and 299/310 (96.5%) of recipients of 3 doses of the Korean and U.S. vaccines, respectively (P = 0.10). There were no meaningful differences in vaccine adverse effects, and 92.6% of recipients of either vaccine completed 3 doses.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Children's Hospital of Eastern Ontario, Ottawa, Canada.
authors.forename: R A
authors.initials: RA
authors.lastname: Pennie
authors.forename: A M
authors.initials: AM
authors.lastname: O'Connor
authors.forename: C S
authors.initials: CS
authors.lastname: Dulberg
authors.forename: A
authors.initials: A
authors.lastname: Bottiglia
authors.forename: P
authors.initials: P
authors.lastname: Manga
authors.forename: C Y
authors.initials: CY
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D003365:Costs and Cost Analysis; D017325:Hepatitis B Vaccines; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D013336:Students, Health Occupations; D011795:Surveys and Questionnaires; D014481:United States; D014611:Vaccination / Q000191:economics* / Q000706:statistics & numerical data; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology
chemical_list: D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic; D014761:Viral Hepatitis Vaccines