title: Intradermal inoculation with Heptavax-B. Immune response and histologic evaluation of injection sites.
abstract: The high cost of hepatitis B vaccine has limited its widespread use. Low-dose, intradermal injections of vaccine represent one option for reducing the cost. In this study, 92 nonimmune medical students were given three 0.1-mL intradermal injections of Heptavax-B containing 2 micrograms of hepatitis B surface antigen (HBsAg) at 0, 1, and 6 months. By 6 months, 90% of the subjects had developed protective levels of antibody to HBsAg (greater than or equal to 10 mIU/mL). Follow-up at 1 year showed a geometric mean concentration of antibodies to HBsAg of 396 mIU/mL for the group, and 95% had levels of antibody to HBsAg greater than or equal to 10 mIU/mL. A level of antibody to HBsAg of greater than 100 mIU/mL also was observed in more than 75% of subjects. Side effects included induration of the inoculation site in 18% at 6 months, which disappeared by 12 months, and macules that persisted at 1 year in 63%. The administration of hepatitis B vaccine intradermally is an attractive, low-cost alternative in the United States, where universal vaccination of preschool children or adolescents is being contemplated, and where booster doses are being considered.
authors.affiliation: Department of Medicine, University of California, Davis, School of Medicine, Sacramento 95817.
authors.forename: J A
authors.initials: JA
authors.lastname: Clarke
authors.forename: F B
authors.initials: FB
authors.lastname: Hollinger
authors.forename: E
authors.initials: E
authors.lastname: Lewis
authors.forename: L A
authors.initials: LA
authors.lastname: Russell
authors.forename: C H
authors.initials: CH
authors.lastname: Miller
authors.forename: A
authors.initials: A
authors.lastname: Huntley
authors.forename: N M
authors.initials: NM
authors.lastname: Flynn
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000276:immunology* / Q000473:pathology / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D017325:Hepatitis B Vaccines; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D012867:Skin / Q000276:immunology / Q000473:pathology*; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage*
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D014761:Viral Hepatitis Vaccines