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Duration of Response to Intramuscular Versus Low Dose Intradermal Hepatitis B Booster Immunization

Published online by Cambridge University Press:  21 June 2016

W. Paul McKinney ,
Susan K. Russler ,
Mary M. Horowitz ,
Richard J. Battiola  and
Martha Bi-Fong Lee
W. Paul McKinney*
Affiliation:
Divisions of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin Infectious Diseases, Medical College of Wisconsin, Milwaukee, Wisconsin
Susan K. Russler
Affiliation:
Infectious Diseases, Medical College of Wisconsin, Milwaukee, Wisconsin
Mary M. Horowitz
Affiliation:
Divisions of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Richard J. Battiola
Affiliation:
Divisions of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Martha Bi-Fong Lee
Affiliation:
Division of Biostatistics and Clinical Epidemiology, Medical College of Wisconsin, Milwaukee, Wisconsin
*
Medical Service (111), Dallas VA Medical Center, 4500 South Lancaster Road, Dallas, TX 75216
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Abstract

Objective:

To determine the duration of the immune response to plasma-derived hepatitis B vaccine among healthcare workers responding to booster doses of intradermal (ID) or intramuscular (IM) vaccine in 1986 and those with protective levels of antibody to hepatitis B surface antigen (anti-HBs) in 1986 without booster vaccine. Both groups received a primary hepatitis B vaccine series 24 to 36 months earlier.

Design:

Cross-sectional follow-up study two years later of an inception cohort defined in 1986.

Setting:

An academically affiliated metropolitan county hospital.

Participants:

Group 1: Hospital employees responding to booster doses of hepatitis B vaccine given ID or IM in 1986 due to low anti-HBs levels. Forty-one (82%) of 50 eligible persons were evaluated. Group 2: Persons not receiving booster vaccine in 1986 due to protective levels of anti-HBs. A random sample of 95 persons was drawn from a pool of 152 participants with protective levels in 1986. sixty-five (68%) of 95 contacted persons were restudied.

Results:

In 1988, 14 (64%) of 22 previous ID responders had anti-HBs levels ≥ 10 milli-international units (mIU)/mL, compared with 17 (89%) of 19 IM responders (p= .055). The 1988 geometric mean titer of IM recipients was 66.4 ±4.5 mIU/mL and of ID recipients was 20.7 ±7.4 (p= .04). None of 65 Group 2 subjects' anti-HBs titers dropped below 10 mIU/mL by 1988.

Conclusions:

plasma-derived hepatitis B vaccine recipients with anti-HBs levels ≥ 10 mIU/mL at 24 to 36 months after primary immunization are likely to maintain these levels two years later. The diminished durability of the antibody response together with the increased rate of local side effects associated with the ID injection route may limit its applicability as an alternative to using IM booster doses of hepatitis B vaccine.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 4 , April 1991 , pp. 226 - 230
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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References

1. Poovorawan, Y, Sanpavat, S, Pongpunlert, W, Chumdermpadetsuk, S, Sentrakul, P, Safary, A. Protective efficacy of a recombinant DNA hepatitis B vaccine in neonates of HBe antigen-positive mothers. JAMA. 1989;261:3278–3281.CrossRefGoogle ScholarPubMed
2. Laukam-Josten, U, Von Laer, G, Feldmeier, H, et al. Active immunization against hepatitis B: immunogenicity of recombinant DNA vaccine in females, heterosexual and homosexual males. Postgrad Med J. 1987;63(suppl):143–146.Google Scholar
3. Hsu, H, Chen, D, Chuang, C, et al. Efficacy of a mass hepatitis B vaccination program in Taiwan. JAMA. 1988;260:2231–2235.CrossRefGoogle ScholarPubMed
4. Wainright, R, McMahon, B, Bulkow, L, et al. Duration of immunogenicity and efficacy of hepatitis B vaccine in a Yupik Eskimo population. JAMA. 1989;261:2362–2366.CrossRefGoogle Scholar
5. Delage, G, Remy-Prince, S, Ducic, S, Pierri, E, Montplaisir, S. Montreal Hepatitis B Virus Immunization Study Group. Combined passive-active immunization against the hepatitis B virus of 132 newborns of chronic carrier mothers: long-term results. Pediatr Infect Dis. 1988;7:769–776.CrossRefGoogle Scholar
6. Ambrosch, F, Frisch-Niggemeyer, W, Kremsner, P, et al. Persistence of vaccine-induced antibodies to hepatitis B surface antigen and the need for booster vaccination in adult subjects. Postgrad Med J. 1987;63(suppl):129–135.Google ScholarPubMed
7. Jilg, W, Schmidt, M, Deinhardt, F. Prolonged immunity after late booster doses of hepatitis B vaccine. J Infect Dis. 1988;157:1267–1269.CrossRefGoogle ScholarPubMed
8. Hadler, S, Francis, D, Maynard, J, et al. Long-term immunogenicity and efficacy of hepatitis B vaccine in homosexual men. N Engl J Med. 1986;315:210–214.CrossRefGoogle ScholarPubMed
9. Centers for Disease Control, Department of Health and Human Services. Recommendations for protection against viral hepatitis. MMWR.1985;34;313–335.Google Scholar
10. Ljunggren, K, Lofgren, B, Nordenfelt, E. Varying antibody response in hospital staff vaccinated against hepatitis B. Scand J Infect Dis. 1988;20:485–488.CrossRefGoogle ScholarPubMed
11. Wismans, P, Van Hattum, J, Stelling, T, Poel, J, de Gast, GC. Effect of supplementary vaccination in healthy non-responders to hepatitis B vaccination. Hepatogastroenterology. 1988;35:78–79.Google ScholarPubMed
12. Weissman, JY, Tsuchiyose, MM, Tong, MJ, Co, R, Chin, K, Ettenger, RB. Lack of response to recombinant hepatitis B vaccine in nonresponders to the plasma vaccine. JAMA. 1988;260:1734–1738.CrossRefGoogle Scholar
13. Craven, DE, Awdeh, ZL, Kunches, LM, et al. Nonresponsiveness to hepatitis B vaccine in health care workers. Ann Intern Med. 1986;105:356–360.CrossRefGoogle ScholarPubMed
14. Seaworth, B, Drucker, J, Starling, J, Drucker, R, Stevens, C, Hamilton, J. Hepatitis B vaccines in patients with chronic renal failure before dialysis. J Infect Dis. 1988;157:332–337.CrossRefGoogle ScholarPubMed
15. Collier, AC, Corey, L, Murphy, VL, Handsfield, HH. Antibody to human immunodeficiency virus and suboptimal response to hepatitis B vaccination. Ann Intern Med. 1988;109:101–105.CrossRefGoogle ScholarPubMed
16. Frazer, IH, Jones, B, Dimitrakakis, M, Mackay, IR. Intramuscular versus low-dose intradermal hepatitis B vaccine. Med J Aust. 1987;146:242–245.CrossRefGoogle ScholarPubMed
17. Wahl, M, Hermodsson, S. Intradermal, subcutaneous or intramuscular administration of hepatitis B vaccine: side effects and antibody response. Scand J Infect Dis. 1987;19:617–621.CrossRefGoogle ScholarPubMed
18. Horowitz, MM, Ershler, WB, McKinney, WP, Battiola, RJ. Duration of immunity after hepatitis B vaccination: efficacy of low-dose booster vaccine. Ann Intern Med. 1988;108:185–189.CrossRefGoogle ScholarPubMed
19. Milne, A, Moyes, CD, Dimitrakakis, M. Low dose hepatitis B vaccination in children: benefit of low dose boosters. N Z Med J. 1988;101:370–371.Google ScholarPubMed
20. Barnaba, V, Levrero, M, Van Dyke, AD, Musca, A, Cordova, C, Balsano, F. T-cell subsets in the hyporesponsiveness to hepatitis B surface antigen and antigen-specific suppressor lymphocytes in chronic hepatitis B virus infection. Clin Immunol Immunopathol. 1985;34:284–295.CrossRefGoogle Scholar
21. Nowicki, M, Tong, MJ, Bohman, RE. Alterations in the immune response of nonresponders to the hepatitis B vaccine. J Infect Dis. 1985;152:1245–1248.CrossRefGoogle Scholar