title: Low dose intradermal vaccination is superior to high dose intramuscular vaccination for hepatitis B in unresponsive hemodialysis patients.
abstract: After two intramuscular (IM) vaccination protocols (40 microg at 0, 1, 2, and 6 months), patients who were unresponsive to hepatitis B vaccination were collected from three HD centers. The aim of this study was to compare the effectiveness of intradermal (ID) and repeated IM vaccination protocols. Thirty-three of 639 HD patients were found to be unresponsive. Patients were randomly assigned into two groups: one to receive 80 microg ID and the other 160 microg IM vaccination protocol. Both ID (p = 0.000) and IM (p = 0.03) groups disclosed statistically significant seroconversion rates six months after the last vaccination dose. The seroconversion rate was 94.1% in the ID and 50% in the IM groups - showing a significant improvement in the ID group (p = 0.011). A low-dose ID is superior to standard IM vaccination protocol and also more cost-effective in unresponsive HD patients.
authors.affiliation: Department of Nephrology, Baskent University Faculty of Medicine, Hospital of Adana, Adana, Turkey. hasanmicoz@hotmail.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Micozkadioglu
authors.forename: Aysegul
authors.initials: A
authors.lastname: Zumrutdal
authors.forename: Dilek
authors.initials: D
authors.lastname: Torun
authors.forename: Siren
authors.initials: S
authors.lastname: Sezer
authors.forename: Fatma Nurhan
authors.initials: FN
authors.lastname: Ozdemir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000209:etiology* / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D007271:Injections, Intradermal / Q000009:adverse effects / Q000191:economics; D007273:Injections, Intramuscular / Q000009:adverse effects / Q000191:economics; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012107:Research Design; D016896:Treatment Outcome; D014421:Turkey; D014611:Vaccination
chemical_list: D015415:Biomarkers; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines