McKinney W P, Russler S K, Horowitz M M, Battiola R J, Lee M B
Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee.
Infect Control Hosp Epidemiol. 1991 Apr;12(4):226-30. doi: 10.1086/646329.
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.
Cross-sectional follow-up study two years later of an inception cohort defined in 1986.
An academically affiliated metropolitan county hospital.
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.
In 1988, 14 (64%) of 22 previous ID responders had anti-HBs levels greater than or equal to 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.
Plasma-derived hepatitis B vaccine recipients with anti-HBs levels greater than or equal to 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.
确定1986年接受皮内（ID）或肌内（IM）加强剂量乙肝疫苗的医护人员以及1986年乙肝表面抗原抗体（抗-HBs）达到保护水平且未接种加强疫苗的人员对血浆源性乙肝疫苗的免疫反应持续时间。两组人员均在24至36个月前接受了乙肝疫苗基础免疫系列接种。
对1986年定义的起始队列进行两年后的横断面随访研究。
一所大学附属医院所在的大城市县医院。
第1组：因抗-HBs水平低而在1986年接受ID或IM加强剂量乙肝疫苗的医院员工。50名符合条件的人员中有41名（82%）接受了评估。第2组：因抗-HBs达到保护水平而在1986年未接种加强疫苗的人员。从1986年具有保护水平的152名参与者中随机抽取95人。95名被联系到的人员中有65名（68%）再次接受研究。
1988年，22名既往接受ID接种者中有14名（64%）抗-HBs水平大于或等于10毫国际单位（mIU）/毫升，而19名IM接种者中有17名（89%）（p = 0.055）。1988年IM接种者的几何平均滴度为66.4±4.5 mIU/毫升，ID接种者为20.7±7.4（p = 0.04）。到了1988年，第2组65名受试者中无一例抗-HBs滴度降至10 mIU/毫升以下。
初次免疫后24至36个月抗-HBs水平大于或等于10 mIU/毫升的血浆源性乙肝疫苗接种者在两年后可能维持这些水平。抗体反应持久性的降低以及与ID注射途径相关的局部副作用发生率的增加可能会限制其作为IM加强剂量乙肝疫苗替代方法的适用性。
