Rivey M P, Peterson J
School of Pharmacy, University of Montana, Missoula 59812.
DICP. 1991 Jun;25(6):628-34. doi: 10.1177/106002809102500612.
The availability of vaccine since 1982 for immunization against hepatitis B virus (HBV) has had minimal impact on the disease; mass immunization has been suggested. Intradermal vaccination, which has precedent in prophylaxis of other infectious diseases, has been investigated as a low-cost alternative to traditional intramuscular HBV vaccination. Results of open and comparative trials indicate similar seroconversion rates for intradermal and intramuscular HBV vaccination routes in healthy adults. However, antibody titers and, presumably, duration of antibody protection appear to be decreased with intradermal HBV vaccination. Limited data suggest that demographic factors such as age and gender may affect vaccine responsiveness to intradermal HBV vaccine. Adverse skin reactions are common but do not represent a deterrent to continued intradermal HBV vaccination. There is a need for large-scale prospective comparative trials to substantiate the value of intradermal HBV vaccination. Nevertheless, the potential economic and epidemiologic benefit of intradermal vaccination justifies continued investigation for prevention of HBV infection.
自1982年以来可获得的用于预防乙型肝炎病毒（HBV）的疫苗对该疾病的影响极小；有人建议进行大规模免疫接种。皮内接种疫苗在其他传染病的预防中有先例，已被作为传统肌肉注射HBV疫苗的低成本替代方法进行研究。开放试验和对比试验的结果表明，健康成年人中皮内和肌肉注射HBV疫苗途径的血清转化率相似。然而，皮内注射HBV疫苗时抗体滴度以及推测的抗体保护持续时间似乎有所降低。有限的数据表明，年龄和性别等人口统计学因素可能会影响对皮内HBV疫苗的反应性。皮肤不良反应很常见，但并不妨碍继续进行皮内HBV疫苗接种。需要进行大规模的前瞻性对比试验来证实皮内注射HBV疫苗的价值。尽管如此，皮内接种疫苗潜在的经济和流行病学益处证明继续研究预防HBV感染是合理的。
