Three doses of hepatitis B vaccine were administered via an intradermal route to 316 health service staff. One month after the final dose, 89.9% of subjects had antibodies to hepatitis B surface antigen at levels of 10 IU/l or greater. A programme of hepatitis B immunization based upon the intradermal route is substantially less expensive than one using an intramuscular technique, and can enable health authorities to provide protection for increased numbers of staff without diverting resources from other programmes of health care.
SzmunessWHarleyEJIkramHSocio-demographic aspects of the epidemiology of hepatitis B. In: VyasGCohenSNSchmidR, eds. Viral hepatitis. Philadelphia: Franklin Institute Press, 1978:297–300.
2.
KrugmanSHolleyPDavidsonM.Immunogenic effect of inactivated hepatitis B vaccine: Comparison of 20 μg and 40 μg doses. J Med Virol1981;8:119–21.
Research Committee of the British Thoracic and Tuber-culosis Association. A comparison of intradermal BCG vaccination by jet injection and by syringe and needle. Tubercle1971;52:155–65.
5.
BardhamPNDattaHNKrishnaswamiP.Intradermal TAB immunisation against enteric infections. J Hyg (Camb)1963;61:365–72.
6.
WhittleHCRowlandMGMMannGFImmunisation of 4–6 month old Gambian infants with Edmonton-Zagreb measles vaccine. Lancet1984;ii:834–7.
7.
HadlerSCMurphyBLSchableCAEpidemiological analysis of the significance of low-positive test results for antibody to hepatitis B surface and core antigens. J Clin Microbiol1984;19:521–5.
8.
FaganEATolleyPSmithHMHepatitis B vaccine: Immunogenicity and follow-up including two year booster doses in high risk health care personnel in a London teaching hospital. J Med Virol1987;21:49–56.
9.
WeberDJRutalaWASamsaGPObesity as a predictor of poor antibody response to hepatitis B plasma vaccine. JAMA1985;254:3187–9.
10.
Centres for Disease Control. Suboptimal response to hepatitis B vaccine given by injection into the buttock. MWWR1985;34:105–8.
11.
RedfieldRRInnisBLScottRMcNClinical evaluation of low dose intradermally administered hepatitis B vaccine: A cost reduction strategy. JAMA1985;254:3203–6.
12.
IrvingWLAlderMKurtzJBIntradermal vaccination against hepatitis B. Lancet1986;ii:1340.
13.
HalseyNAReppertEJMargolisHSIntradermal hepatitis B vaccination: An abbreviated schedule. Vaccine1986;4:228–31.
14.
FaddaGMaidaAMasiaCEfficacy of hepatitis B immunisation with reduced intradermal doses. Eur J Epidemiol1987;3:176–80.
15.
PrasetyaELinngadajaWSymbaliRIntradermal vaccination against hepatitis B in Immanuel Hospital personnel—a preliminary report. Ann Acad Med Singapore1986;15:153–7.
16.
FrazerIHJonesBDimitrakakisMIntramuscular versus low-dose intra-dermal hepatitis B vaccine: Assessment by humoral and cellular immune response to hepatitis B surface antigen. Med J Aust1987;146:242–5.
17.
MilneAAllwoodGKPearceNELow dose hepatitis B vaccination in children. N Z Med J1986;99:47.
18.
WahlMHermodssonS.Intradermal, subcutaneous or intramuscular administration: Side effects and antibody response. Scand J Infect Dis1987;19:617–21.
19.
PathakUNDilawariJBChawlaYImmunogenicity and side effects of low dose intradermally administered hepatitis B vaccine. Indian J Gastroenterol1988;7:113–14.
20.
HeijtinkRABreukersAAden HartighGLow dose intradermal vaccination against hepatitis B in mentally retarded patients. Vaccine1988;6:59–61.
21.
IrvingWLParsonsAJKurtzJBIntradermal hepatitis B vaccine. Lancet1987;ii:561.
22.
IbranyiEMihalyINagyE.Alacsony dozisu intradermalis vakcinacio B virus hepatitis megelozesere. Orv Hetil1988;129:1967–8.
23.
McAleerWJBuynakEBMaigetterRZHuman hepatitis B vaccine from recombinant yeast. Nature1984;307:178–80.
24.
KurtzJBAlderMJMayon-WhiteRTPlasma-derived versus recombinant hepatitis B vaccines. Lancet1989;i:451.
