Intradermal hepatitis B immunization with yeast-derived vaccine: serological response by sex and age.
The efficacy and acceptability of yeast-derived recombinant hepatitis B vaccine given by the intradermal route was investigated in 221 health care volunteers. Two hundred and sixteen received a full course of three doses of vaccine. Only one subject was withdrawn because of a significant adverse reaction (psoriasis). The vaccine stimulated an antibody response in 81%. The response to the vaccine was better in women than in men (87% compared with 71%, p = 0.007) and in women below the age of 40 years compared with older women (94% compared with 76%, p = 0.01). For men the response showed a sequential decline with age for each decade (90% responders from age 29 or less, 72% aged 30-39 and 65% aged 40 or more, p = 0.04). Retrospective enquiry showed that over 90% had found the intradermal route acceptable and 59% would prefer vaccine by the intradermal route in preference to intramuscular notwithstanding local reactions. Although the seroconversion rate was of a high order in younger women the antibody titres were not high with only 9 of 215 recipients developing titres greater than 1000 mIU/ml, a level which could be expected to ensure prolonged immunity. A fourth intradermal dose of vaccine given to 60 volunteers who had shown a low response (less than 38 mIU/ml) or no serological response to a three-dose course stimulated a good booster effect (to 150-600 mIU/ml) in only 5 (8%).
Morris
C A
CA
Public Health Laboratory, Royal Shrewsbury Hospital, Shropshire.
Oliver
P R
PR
Reynolds
F
F
Selkon
J B
JB
D000328:Adult; D000367:Age Factors; D005260:Female; D006510:Hepatitis B Antibodies / Q000096:biosynthesis*; D017325:Hepatitis B Vaccines; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic; D014761:Viral Hepatitis Vaccines