Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-15T01:32:25.606Z Has data issue: false hasContentIssue false

Intradermal hepatitis B immunization with yeast-derived vaccine: serological response by sex and age

Published online by Cambridge University Press:  15 May 2009

C. A. Morris
Affiliation:
Public Health Laboratory, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury, Shropshire, SY3 8XH
P. R. Oliver
Affiliation:
Public Health Laboratory, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury, Shropshire, SY3 8XH
F. Reynolds
Affiliation:
Public Health Laboratory, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury, Shropshire, SY3 8XH
J. B. Selkon
Affiliation:
Public Health Laboratory, John Radcliffe Infirmary, Headington, Oxford, 0X3 9DU
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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 Only one subject was withdrawn because of a significant adverse reaction (psoriasis).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 >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 (<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%).

Type
Research Article
Copyright
Copyright © Cambridge University Press 1989

References

REFERENCES

1.Zuckerman, AJ.Appraisal of intradermal immunisation against hepatitis B. Lancet 1987; 1: 435–6.CrossRefGoogle ScholarPubMed
2.Miller, KD, Gibbs, RD, Mulligan, MM, Nutman, TB, Francis, DP.Intradermal hepatitis B vaccine. Immunogenicity arnl side effects in adults. Lancet 1983; 2: 1454–6.CrossRefGoogle Scholar
3.Dienstag, JL.Low dose intradermal hepatitis B vaccine. JAMA 1986; 256: 351.CrossRefGoogle ScholarPubMed
4.Irving, WL, Alder, M, Kurtz, JB, Juel-Jensen, B.Intradermal vaccination against hepatitis B. Lancet 1986; 2: 1340.CrossRefGoogle ScholarPubMed
5.Nagafuchi, S, Kashiwagi, S.Reversal by intradermal hepatitis B vaccination of unresponsiveness to HBsAg. Lancet 1987: 2: 1522–3.CrossRefGoogle ScholarPubMed
6.Praesetya, E, Linggadjaja, W, Syambali, R, Kusmo, S, Dharmesetyawan, D, Ramardja, U.Intradermal vaccination against hepatitis B in hospital personnel. Ann Acad Med Singapore 1986; 15: 153–7.Google Scholar
7.Milne, A.Tntramuseular versus intradermal hepatitis B vaccination. NZ Med J 1986: 99: 640.Google ScholarPubMed
8.Frazer, TH, Jones, B, Dimitrakakis, M, Mackay, IR.Intramuscular versus low dose intradermal hepatitis B vaccine. Assessment by humoral and cellular immune response to hepatitis B surface antigen. Med J Aust 1987: 146: 242–5.CrossRefGoogle ScholarPubMed
9.Fadda, G, Maida, A, Masia, C, Obino, G, Romano, G, Spano, E.Efficacy of hepatitis B immunisation with reduced intradermal doses. Eur J Epidemiol 1987; 3: 176–80.CrossRefGoogle ScholarPubMed
10.Halsey, NA, Reppert, EJ, Margolis, HS, Francis, DP, Fields, HA.Intradermal hepatitis B vaccination in an abbreviated schedule. Vaccine 1986: 4: 228–32.CrossRefGoogle Scholar
11.Goldwater, PN, Woodfield, DG, Ramirez, AM, Steed, I.Intradermal. low dose, short course hepatitis B vaccination. NZ Med J 1986: 99: 703–5.Google ScholarPubMed
12.Whittle, HC, Lamb, WM, Ryder, RW.Trials of intradermal hepatitis B vaccine in Gambian children. Ann Trop Paediatr 1987: 7: 69.CrossRefGoogle ScholarPubMed
13.Ayoola, EA, Atoba, MA, Johnson, AO.Intradermal vaccination against hepatitis B virus infection in an endemic area (Nigeria), two year results. Arch Virol 1986: 91: 291–6.CrossRefGoogle Scholar
14.Irving, WL, Parsons, AJ, Kurtz, JB, Juel-Jensen, BE.Intradermal hepatitis B vaccine. Lancet 1987: 2: 561.CrossRefGoogle ScholarPubMed
15.Horowitz, MM, Ershler, WM, McKinney, WP, Battiola, RJ.Duration of immunity after hepatitis B vaccination: efficacy of low-dose booster vaccine. Ann Intern Med 1988: 108: 185–9.CrossRefGoogle ScholarPubMed
16.Nagafuchi, S, Kashiwagi, S, Lnoue, T, Imayama, S.Development of skin reactions to hepatitis B vaccine in man. Microbiol Immunol 1984: 28: 275–9.CrossRefGoogle ScholarPubMed
17.Joint Committee on Vaccination and Immunisation. Immunisation against infections. London: Hmso, 1988: 76.Google Scholar
18.Jilg, W, Schmidt, M, Zoulek, G, Lorbeer, B, Wilske, B, Deinherdt, F.Clinical evaluation of a recombinant hepatitis B vaccine. Lancet 1984: 2: 1174–5.CrossRefGoogle ScholarPubMed
19.Rook, A, Wilkinson, DS, Ebling, FJ, Champion, RH, Burton, JL. eds. Textbook of dermatology. 1986. 4th ed vol 1. Oxford: Blackwell Scientific Publications.Google Scholar
20.Alexander, J, Stimson, WH.Sex hormones and the course of parasitic infection. Parasitology Today, 1988; 4: Part 7; 189–93.CrossRefGoogle Scholar
21.Morbidity and Mortality Weekly Report. Trends: safety of hepatitis B vaccine. J Amer Med Assoc 1983, 249: 1812.CrossRefGoogle Scholar
22.Carreno, V, et al. Vaccination against hepatitis B in renal dialysis units. Clin Nephrol 1985: 24: 215–20.Google ScholarPubMed
23.Saxonhouse, WJ.Hepatitis vaccine. J Am Dent Assoc 1985: 110: 670.CrossRefGoogle ScholarPubMed
24.Andre, Fe, Safary, A.Summary of clinical findings on Engerix-B, a genetically engineered yeast-derived hepatitis B vaccine. Postgrad Med J 1987; 63 (Suppl 2), 169–78.Google ScholarPubMed