Low-dose intradermal versus intramuscular administration of recombinant hepatitis B vaccine:: a comparison of immunogenicity in infants and preschool children

Low-dose intradermal versus intramuscular administration of recombinant hepatitis B vaccine:: a comparison of immunogenicity in infants and preschool children
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DOI:
10.1016/s0264-410x(98)80006-6
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发表时间:
1998-10-01
期刊:
影响因子:
5.5
通讯作者:
Akilli, M
Akilli, M
中科院分区:
医学3区
文献类型:
--
作者:
Egemen, A;Aksit, S;Akilli, M

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200名婴儿和200名学龄前儿童被随机分配在0、1和6个月时接受10 μ g重组乙型肝炎疫苗(GenHevac B)肌肉注射(IM)或2 μ g三角肌皮下注射(ID)。第三次接种后8周检测乙型肝炎表面抗原抗体(anti-HBs)。重组乙肝疫苗的标准剂量IM和低剂量ID产生的抗- hbs率等于或高于20 mIU ml(-1)的婴儿(分别为98%和94%)和学龄前儿童(分别为98%和100%)相当。尽管IM疫苗在婴儿(几何平均滴度-GMT, 935对621 mIU ml(-1))和学龄前儿童(GMT 1393对804 mIU ml(-1))中产生的抗hbs浓度高于ID疫苗,但差异无统计学意义(p > 0.05)。学龄前儿童的抗hbs浓度高于婴儿。两组疫苗均未见临床严重不良反应;然而,注射部位的硬结和色素沉着在皮内接种疫苗的研究人群中更为常见。我们的结论是,在婴儿和学龄前儿童中皮内注射2 μ g重组乙型肝炎疫苗是安全有效的,并且可能是一种可接受的、更便宜的大规模免疫接种替代全剂量IM疫苗的方法,特别是在发展中国家。1998爱思唯尔科学有限公司版权所有。
Two hundred infants and two hundred preschool children were randomly assigned to receive either 10 mu g of recombinant hepatitis B vaccine (GenHevac B) intramuscular ly (IM) or 2 mu g intradermally (ID) in the deltoid region at 0, 1 and 6 months. Antibody to hepatitis B surface antigen (anti-HBs) was tested eight weeks after the third vaccine dose. Standard dose IM and low-dose ID administration of recombinant hepatitis B vaccine produced comparable rates df anti-HBs equal to or higher than 20 mIU ml(-1) infants (98% and 94%, respectively) and preschool children (98% and 100%, respectively). Although IM vaccination produced higher anti-HBs concentrations than ID vaccination both in infants (geometric mean titre-GMT, 935 versus 621 mIU ml(-1)) and preschool children (GMT 1393 versus 804 mIU ml(-1)), the differences were not statistically significant (p > 0.05). The preschool children tended to have higher anti-HBs concentrations than the infants. No clinically serious adverse effects were observed in both vaccine groups; however induration and hyperpigmentation at the injection site were more often seen in the study population that was vaccinated intradermally. We conclude that intradermal administration of 2 mu g recombinant hepatitis B vaccine is safe and effective in infants and preschool children, and may be an acceptable, less expensive alternative to full-dose IM vaccination for mass immunization, especially in developing countries. (C) 1998 Elsevier Science Ltd. All rights reserved.