title: Comparison of Accelerated and Standard Hepatitis B Vaccination Schedules in High-Risk Healthy Adults: A Meta-Analysis of Randomized Controlled Trials.
abstract: BACKGROUND
  Selecting the most efficient vaccination schedule is an important issue.
  
  
  OBJECTIVE
  To assess the beneficial and harmful effects of accelerated hepatitis B vaccination schedules in high-risk healthy adults.
  
  
  METHODS
  We searched controlled trial registers of The Cochrane Library as well as MEDLINE, EMBASE, VIP Database for Chinese Technical Periodicals, and the Chinese National Knowledge Infrastructure databases for randomized controlled trials published up to December 2013 that compared accelerated hepatitis B vaccine schedules to the standard schedule in adults. The results were presented as relative risk with 95% confidence intervals. Fixed or random effect models were used for analysis.
  
  
  RESULTS
  We identified 10 randomized trials, all with one or more methodological weaknesses. Compared to the standard schedule, most accelerated schedules resulted in higher proportions of healthy vaccines more rapidly reaching anti-hepatitis B antibody levels >10 IU/L (P<0.05) initially and maintaining similar seroprotection rates after 6 months (P>0.05). Although accelerated schedules produced anti-hepatitis B levels higher than the standard schedule for the first month after the initial vaccine dose, they were significantly lower than the standard schedule after 6 months, except for an accelerated schedule that called for a fourth booster injection 12 months after the initial dose. Subjects administered accelerated vaccine schedules had similar compliance rate as those administered the standard schedule over the first 6 months of vaccination (relative risk = 1.00, 95% confidence interval: 0.84-1.21).
  
  
  CONCLUSIONS
  For rapid seroconversion and almost immediate short-term protection, accelerated vaccination schedules could be useful for at-risk groups. However, additional studies on the long-term protection and effectiveness of the primary doses of accelerated schedules are necessary.
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Jin
authors.affiliation: Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China.
authors.forename: Zhaoying
authors.initials: Z
authors.lastname: Tan
authors.affiliation: Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
authors.forename: Yueyuan
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China; Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
authors.forename: Pei
authors.initials: P
authors.lastname: Liu
mesh_terms: D000328:Adult; D006509:Hepatitis B / Q000276:immunology* / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D007115:Immunization Schedule; D017063:Outcome Assessment, Health Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013997:Time Factors; D014611:Vaccination / Q000379:methods*
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines