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.
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.