The comparison of intradermal versus intramuscular vaccination of hepatitis B in healthcare workers who fail to respond to previous repeated intramuscular vaccines

Abstract

Vaccination is recommended for all healthcare workers (HCWs) at risk of exposure to blood and body fluids to prevent occupational acquisition of hepatitis B virus (HBV). However, about 5% of HCWs after 6 doses of intramuscular injections of vaccines fail to develop protective antibody levels (anti HBs). These groups are named non-responder. To compare the humoral immune responses of intramuscular (IM) and intradermal (ID) vaccination in non-responder HCWs, we designed an open, prospective trial. In this trial, we chose HCWs who did not respond to several booster doses of IM hepatitis B vaccine. Three doses of IM or ID recombinant vaccine were injected with two weeks interval in each group. Hepatitis B antibody responses (anti HBs) were assessed one month after last injection. Seroconvertions were observed in 95.5% of ID group and 85% of IM group of these non-responder subjects after vaccinations. ID recombinant hepatitis B vaccination induced protective antibody responses in more than 95.5% of HCWs non-responsive to repeated IM hepatitis B vaccination and can be considered for all non-responder HCWs. Key words: Vaccination, healthcare workers, nonresponder, hepatitis B virus.