Ramon J M, Bou R, Oromi J
Preventive Medicine Department, Ciudad Sanitaria de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
Vaccine. 1996 Dec;14(17-18):1647-50. doi: 10.1016/s0264-410x(96)00134-x.
Little research has been conducted on low booster doses in adults and only intradermal (i.d.) inoculation has been used with high rates of adverse reactions among subjects i.d. revaccinated. The present study compare a low intramuscular dose of recombinant hepatitis B vaccine with standard 20 micrograms revaccination. We studied 122 hospital workers 5 years after vaccination with recombinant hepatitis B vaccine who were randomly allocated to either the study group or control group. The study group received revaccination with 0.1 ml (2 micrograms) of recombinant hepatitis B vaccine and the control group 1.0 ml (20 micrograms). Two micrograms of i.m. vaccine was as effective as 20 micrograms i.m. in inducing antibody response and the antibody decrease after revaccination between groups was similar (P > 0.05) and independent of the initial concentration of anti-HBs after revaccination and dose (20 micrograms vs 2 micrograms). In conclusion, in subjects who had received a standard hepatitis B vaccination and had showed anti-HBs titres higher or equal than 10 mIU ml-1 after vaccination, low i.m. booster doses of vaccine give a rapid anamestic response similar to standard revaccination with less adversal reactions than low i.d. administered dose and would be an effective and less expensive alternative to revaccination against HBV of populations at high risk.
针对成人低剂量加强疫苗的研究较少，且仅采用皮内接种，再次皮内接种的受试者不良反应发生率较高。本研究比较了低剂量肌肉注射重组乙型肝炎疫苗与标准20微克再次接种的效果。我们对122名接种重组乙型肝炎疫苗5年后的医院工作人员进行了研究，他们被随机分为研究组或对照组。研究组接受0.1毫升（2微克）重组乙型肝炎疫苗再次接种，对照组接受1.0毫升（20微克）。2微克肌肉注射疫苗在诱导抗体反应方面与20微克肌肉注射疫苗效果相同，两组再次接种后抗体下降情况相似（P>0.05），且与再次接种后抗-HBs初始浓度和剂量（20微克对2微克）无关。总之，在接受标准乙型肝炎疫苗接种且接种后抗-HBs滴度高于或等于10 mIU/ml的受试者中，低剂量肌肉注射加强疫苗能产生与标准再次接种相似的快速回忆反应，不良反应比低剂量皮内接种少，是高危人群预防乙肝再次接种的一种有效且成本较低的替代方法。
