Administration Of Recombinant Hepatitis Research Articles

Central-nervous-system demyelination after immunisation with recombinant hepatitis B vaccine

2 patients had neurological symptoms and signs, with evidence of central-nervous-system demyelination, 6 weeks after administration of recombinant hepatitis B vaccine. 1 had known multiple sclerosis but the other had no history of neurological disease; both had HLA haplotypes DR2 and B7, which are associated with multiple sclerosis. A causal link between vaccination and demyelination cannot be established from these 2 case-reports, but the time interval would fit a proposed immunological mechanism.

Antibody Response after Intradermal Administration of Recombinant Hepatitis B Vaccine in Children

Intradermal vaccination with recombinant hepatitis B vaccine was performed in 33 children (mean age 3.3 years). A 2 micrograms dose was given at 0, 1 and 6 months and antibody responses were determined 20 months after the initial dose. In 32/33 children, serum antibodies to HBs were demonstrated, with a geometric mean level of 26.5 IU/l, and 24 children (73%) had anti-HBs levels greater than or equal to 10 IU/l. The results indicate that intradermal vaccination with recombinant hepatitis B vaccine may be an alternative for vaccination of small children.

Immunogenisity of the intradermal route of hepatitis B vaccination with the use of recombinant hepatitis B vaccine

In March 1987, 32 hospital employees were enrolled in a prospective trial of intradermal recombinant hepatitis B vaccination. Enrollees were given 0.1 ml of vaccine on days 1, 30, and 180. Two weeks after the third intradermal vaccination, 81%, or 26, of the enrollees showed seropositivity (⩾ 10 mIU antibody / ml) for hepatitis B surface antibody. Five of six nonresponders were given a fourth intradermal vaccination. Two additional seroconversions occurred, resulting in an overall conversion rate of 90% for recipients of up to four intradermal vaccine doses. Complications of vaccination were limited primarily to the occasional persistence (less than 6 months) of hyperpigmentation at the injection site. Administration of recombinant hepatitis B vaccine by the intradermal route proved to be a safe and effective method of vaccination. Cost savings of preexposure immunization with the intradermal versus the intramuscular route of vaccination were approximately $90 per enrollee. Efficacy and safety can be maximized by employing a fourth vaccine dose and routinely documenting seroconversion after vaccination. ( Am J Infect Control 1989;17:126–129)