Immunization with high-dose intradermal recombinant hepatitis B vaccine in healthcare workers who failed to respond to intramuscular vaccination.

OBJECTIVE

To achieve immunity to hepatitis B in healthcare workers who failed to respond to intramuscular vaccination and boosters.

DESIGN

An open prospective study of intradermal vaccination with recombinant hepatitis B vaccine.

SETTING

A large community hospital in Connecticut.

PARTICIPANTS

Healthcare workers including physicians, nurses, and laboratory workers.

RESULTS

Immunization with high-dose intradermal recombinant hepatitis B vaccine, given in up to four doses, achieved immunity in 88% of healthcare workers who had previously been nonimmune.

CONCLUSIONS

We conclude that intradermal vaccination is efficacious in the majority of healthcare workers who failed to respond to intramuscular vaccine. Further studies, including randomized comparisons with intramuscular vaccine as well as studies of cell-mediated immunity, appear warranted.