Intramuscular Versus Intradermal Hepatitis B Revaccination in Healthy Non-Responder Children: a 5-year Prospective Randomized Study

摘要

With the same times of injection to compare low-dose intradermal regimen with routine-dose intramuscular inoculation in revaccination of non-responders to hepatitis B vaccine. Methods 40 healthy non-responder children collected by screening were administrated a three-dose revaccination randomly by intramuscular or intradermal route (10 vs 2 g per dose) , and regularly tested for serologic markers up to five years. By the end of follow-up, a booster dose (5 mu g) was given to those who had lost anti-HBs of >=10 m IU/mL (seroprotection) and anamnestic response was estimated thereafter. Results All 17 intramuscular and 22 of 23 intradermal children effected seroprotection after revaccination, Intradermal children lost seroprotection over time significantly rapider compared with intramuscular children (Log Rank test, P= 0. 029). In year 5, 50 percent of intramuscular but only 18. 2 percent of intradermal children still maintained seroprotection (P=0. 075). 12 - 14 days after the booster dose, all the eight intramuscular children developed an anamnestic response with anti-HBs titer increasing greater, but two of the 18 intradermal children failed to mount seroprotective level. Conclusion Three-routine-dose intramuscular revaccination was significantly effective than low-dose intradermal one with the same times of injection, especially in long-term immunity. We recommend routine-dose intramuscular protocol in revaccination of non-responders.