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A low-dose intradermal hepatitis B vaccine programme in health-care workers and students is highly effective and cost saving: a retrospective follow-up survey in the clinical setting
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
2008 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, Vol. 43, no 4, 465-472 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To evaluate compliance, serologic response and the cost-benefit of a low-dose intradermal hepatitis B vaccination programme, followed by intramuscular boosters in non-responders. MATERIAL AND METHODS: The study comprised a retrospective survey of 1521 health-care workers and 968 students. Response was defined as hepatitis B antibody titres > or =10 IU/L. Non-response included vaccinees with undetectable antibodies and a hypo-response if antibodies were detectable. RESULTS: Overall, 2145/2489 (86%) subjects completed the intradermal series, whereof 1840/2489 (74%) complied with the serological check-up. Response was achieved in 1517/1840 (82.5%), whereas 107/1840 (5.8%) had a hypo-response and 216/1840 (11.7%) had an undetectable response. In a logistic regression model, younger age (odds ratio 0.73 (95% CI: 0.65-0.82, p<0.001)) and female gender (odds ratio 2.16 (95% CI: 1.67-2.80; p<0.001)) were predictive of response. In hypo-responders and those with undetectable responses, 43/46 (94%) and 71/136 (52%), respectively, had a response after the first intramuscular booster. Hence, in compliant vaccinees an overall seroprotection rate of 94% was reached after a single intramuscular booster. A cost-benefit analysis indicated a cost reduction exceeding 50% compared to a standard intramuscular vaccine regimen. CONCLUSIONS: In the clinical setting, a low-dose intradermal hepatitis B vaccination programme, followed by intramuscular boosters to non-responders, is effective and cost saving.

Place, publisher, year, edition, pages
2008. Vol. 43, no 4, 465-472 p.
Keyword [en]
compliance, cost-benefit, hepatitis B vaccination, intradermal, intramuscular booster, low-dose, response
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-89261DOI: 10.1080/00365520701733806ISI: 000254347500011PubMedID: 18365912OAI: oai:DiVA.org:uu-89261DiVA: diva2:159781
Available from: 2009-02-10 Created: 2009-02-10 Last updated: 2009-11-12Bibliographically approved

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