Hellgren T E
J Fla Med Assoc. 1989 Apr;76(4):399-402.
Several factors concerning effectiveness of the hepatitis B virus (HBV) vaccination have been discovered: site of injection, indications for revaccination, testing for immunity, persistence of HBV antibody following vaccination, and age of recipient. The site may be important in provoking an appropriate antibody response. The deltoid is recommended rather than the gluteal. It is suggested that recipients of gluteal vaccinations receive revaccination in the deltoid. Revaccination is also recommended five years after the original series due to possible loss of antibody response. This is especially important to those with continued exposure to HBV such as medical personnel. However, caution is suggested as undetectable antibody appears to be an unreliable predictor of susceptibility to infection. It is also recommended that testing for immunity after vaccination be conducted only in those in whom a suboptimal response is expected, i.e., gluteal injection recipients and immunocompromised patients. Age of the recipient appears to be a major confounder influencing the duration of vaccine-induced immunity. The physician's consideration of these factors when administering the HBV vaccine should increase the overall effectiveness of immunization.
关于乙肝病毒（HBV）疫苗接种效果的几个因素已被发现：注射部位、加强免疫的指征、免疫检测、接种疫苗后HBV抗体的持久性以及接种者的年龄。注射部位对于激发适当的抗体反应可能很重要。建议在三角肌部位接种，而不是在臀肌部位。有人建议在臀肌部位接种疫苗的人应在三角肌部位进行加强免疫。由于抗体反应可能丧失，也建议在初次接种系列疫苗五年后进行加强免疫。这对那些持续接触HBV的人（如医务人员）尤为重要。然而，有人建议要谨慎，因为无法检测到抗体似乎并不是易感染性的可靠预测指标。还建议仅对那些预期免疫反应欠佳的人（即臀肌注射者和免疫功能低下的患者）进行接种后免疫检测。接种者的年龄似乎是影响疫苗诱导免疫持续时间的一个主要混杂因素。医生在接种HBV疫苗时考虑这些因素应能提高免疫接种的总体效果。
