Dr Per Sangfelt and colleagues from Sweden evaluated compliance, serologic response, and the cost-benefit of a low-dose intradermal Hepatitis B vaccination program, followed by intramuscular boosters in non-responders.
The team undertook a retrospective survey of 1,521 health-care workers, and 968 students.
|Overall seroprotection rates of 94% was reached after a single intramuscular booster|
|Scandinavian Journal of Gastroenterology|
Response was defined as Hepatitis B antibody titres 10 IU/L.
Non-response included vaccinees with undetectable antibodies, and a hypo-response if antibodies were detectable.
The research team found that overall, 2145 subjects completed the intradermal series, of whom 1840 complied with the serological check-up.
Response was achieved in 83%, whereas 6% had a hypo-response, and 12% had an undetectable response.
Using a logistic regression model, the research team found that younger age, and female gender were predictive of response.
In 46 hypo-responders, and 136 with undetectable responses, 94%, and 52%, respectively, had a response after the first intramuscular booster.
Hence, in compliant vaccinees an overall seroprotection rate of 94% was reached after a single intramuscular booster.
The team noted that a cost-benefit analysis indicated a cost reduction exceeding 50% compared to a standard intramuscular vaccine regimen.
Dr Sangfelt's team concluded, "In the clinical setting, a low-dose intradermal Hepatitis B vaccination program, followed by intramuscular boosters to non-responders, is effective, and cost saving."