title: Intradermal recombinant hepatitis B vaccine for healthcare workers who fail to respond to intramuscular vaccine.
abstract: OBJECTIVE
  To study the humoral immune responses, safety, and tolerability of intradermal recombinant hepatitis B vaccination in healthcare workers (HCWs) nonresponsive to previous repeated intramuscular vaccination.
  
  
  METHODS
  An open, prospective, before-after trial.
  
  
  METHODS
  A tertiary referral hospital and surrounding district health service in Queensland, Australia.
  
  
  METHODS
  Hospital and community HCWs nonresponsive to previous intramuscular hepatitis B vaccination.
  
  
  METHODS
  Intradermal recombinant hepatitis B vaccine was administered every second week for a maximum of 4 doses. Hepatitis B surface antibody (anti-HBs) responses were assessed 2 weeks after each dose.
  
  
  RESULTS
  Protective anti-HBs levels developed in 17 (94%) of 18 study subjects. Three doses resulted in seroconversion of all responding subjects and the highest geometric mean antibody concentration. The vaccine was well tolerated.
  
  
  CONCLUSIONS
  More than 90% of previously nonresponsive HCWs responded to intradermal recombinant hepatitis B vaccine with protective anti-HBs levels.
authors.affiliation: Infection Management Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: E Geoffrey
authors.initials: EG
authors.lastname: Playford
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Hogan
authors.forename: Amolak S
authors.initials: AS
authors.lastname: Bansal
authors.forename: Kareena
authors.initials: K
authors.lastname: Harrison
authors.forename: David
authors.initials: D
authors.lastname: Drummond
authors.forename: David F M
authors.initials: DF
authors.lastname: Looke
authors.forename: Michael
authors.initials: M
authors.lastname: Whitby
mesh_terms: D000328:Adult; D000488:Allied Health Personnel; D000917:Antibody Formation; D015992:Body Mass Index; D005260:Female; D006509:Hepatitis B / Q000276:immunology* / Q000517:prevention & control; D006514:Hepatitis B Surface Antigens / Q000276:immunology* / Q000302:isolation & purification; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006801:Humans; D007271:Injections, Intradermal; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011793:Queensland
chemical_list: D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines