Comparison of intradermal and intramuscular hepatitis B vaccination in university students

Herbert, M; Butler, AM; Roome, A.P.C.H.; Caul, E.O.

doi:10.1016/0264-410x(89)90151-5

Cited by 17 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite these impediments, we have recently demonstrated that the human antibody response to immunization with the HBsAg vaccine is MHC associated. Many clinical studies have demonstrated that up to 7.5% of otherwise healthy HBsAg vaccine recipients are poor or nonresponders (5)(6)(7)(8)(9)(10)(11). In our initial study of a group of such nonresponders, we noted an increased incidence of individuals presumably homozygous (by phenotype) for the HLA class I gene HLA-B8, the class II gene HLA-DIL3, and the genes for the complement proteins BF*S, C2"C, C4A*QO (a null gene), and C4B'1 (12).…”

mentioning

confidence: 99%

The immune response to hepatitis B vaccine in humans: inheritance patterns in families.

Kruskall

Alper

Awdeh

et al. 1992

The Journal of Experimental Medicine

135

View full text Add to dashboard Cite

Sl~1"EllrlaryWe have recently shown that the human antibody response to the hepatitis B virus surface antigen (HBsAg) vaccine is major histocompatibility complex (MHC) associated. In studies of nonresponders to the vaccine, we found an increased incidence of individuals homozygous for human histocompatibility leukocyte antigen (HLA) proteins associated with the extended (conserved) haplotype SC01,DR3]. In later prospective vaccination trials, we showed that none of five individuals homozygous for this haplotype developed more than 1,300 radioimmunoassay (RIA) units of antibody (mean, 467 RIA units), while all heterozygotes made at least 2,500 RIA units (mean antibody level, 15,608 units). Our results suggested that [HLA-B8,SC01,DR3] lacks an immune response gene for HBsAg, and that response is inherited in a dominant fashion. To provide further evidence for this hypothesis, we have now analyzed the results of HBsAg immunization in families. 43 members of 10 families were immunized with the hepatitis B vaccine, including seven families where at least one member bore the haplotype [HLA-BS,SC01,DR3], and three families where one member had already received, but failed to respond to, the vaccine. In two of these three families, the presence of [HLA-BS,SC01,DR3] was subsequently found. Of nine MHC-identical sibling pairs in the study, both members of eight pairs had similar antibody responses (five nonresponder and three responder pairs). In all families with such sibling pairs, including the discordant pair, rank-ordering members by antibody level demonstrated that no relative's value came between the sibling pair values. Furthermore, of nine [HLA-BS,SC01,DR3]-haplotypehomozygous individuals, six were nonresponders, and two others had only low-normal responses.[HLA-BS,SC01,DR3]-heterozygous family members always had higher levels of antibody than their homozygous relatives. Linkage analysis of nonresponse to HLA haplotypes revealed a maximum likelihood LOD (logarithm of the odds) score of 6.3 at a recombination fraction of 0.1. The MHC association with lack of antibody response to HBsAg was not seen with tetanus immunization, where 1 of 20 HBsAg responders and 1 of 21 poor or nonresponders had tetanus titers of <1:512; both tetanus nonresponders were [HLA-B8,SC01,DR3] heterozygotes. Our results indicate that: (a) response to the HBsAg vaccine is MHC linked, and inherited in a dominant fashion; (b) an abnormal or missing immune response (Ir) gene for HBsAg is a characteristic of most examples of the extended haplotype [HLA-B8,SC01,DR3]; and (c) other haplotypes also have abnormal or missing Ir genes for HBsAg.

show abstract

mentioning

confidence: 99%

The immune response to hepatitis B vaccine in humans: inheritance patterns in families.

Kruskall

Alper

Awdeh

et al. 1992

The Journal of Experimental Medicine

135

View full text Add to dashboard Cite

show abstract

“…Forty-one studies compared ID delivery to IM immunisation and just two studies [ 105 , 115 ] compared ID to SC delivery. The identified studies were conducted in healthy adults (n = 21) (predominantly healthcare workers and medical students) [ 17 , 90 , 93 , 95 , 99 , 100 , 102 , 103 , 106 , 107 , [117] , [118] , [119] , [120] , 122 , 123 , 125 , 126 , [128] , [129] , [130] , [131] ], haemodialysis patients (n = 9) [ 92 , [96] , [97] , [98] , 108 , 113 , 114 , 121 , 124 ], chronically ill patients (including HIV, coagulation disorders, sickle cell disease or β-thalassaemia) (n = 4) [ 110 , 112 , 115 , 116 ], and children (0–18 years) n = 10) [ 90 , 91 , 94 , 101 , 104 , 105 , 109 , 111 , 112 , 127 ]. The vast majority of studies mentioned participants having no history of immunisation with HBV or having negative HBsAg, anti -HBs and anti -HBc, which rendered previous immunisation unlikely.…”

Section: Resultsmentioning

confidence: 99%

“…Both plasma-derived and recombinant HBV vaccines were included in this review. Most studies used the WHO-recommended [ 191 ] three-dose schedule, administering the first two doses one month apart and the third dose 1–12 months later (n = 28) [ 17 , [90] , [91] , [92] , [93] , [100] , [101] , [102] , [103] , [105] , [106] , [107] , 109 , 113 , [115] , [116] , [117] , [118] , [119] , [120] , [121] , [122] , [123] , 125 , 126 , 128 , 130 , 131 ]. Seven studies used a different ID regimen, administering vaccine either every week [ 98 ], every two weeks [ 96 , 97 , 111 , 112 , 129 ], or monthly [ 108 ].…”

Section: Resultsmentioning

confidence: 99%

“…All studies reported immunogenicity as their primary outcome; 29 studies reported safety as secondary outcome [ 17 , 93 , 94 , [96] , [97] , [98] , [99] , [100] , [101] , [102] , [103] , [104] , [105] , [106] , [107] , 109 , 110 , 114 , 115 , 118 , 119 , 121 , [123] , [124] , [125] , [126] , 128 , 129 , 131 ], and two studies [ 96 , 105 ] mentioned costs. The majority of studies (n = 38) reported seroprotection rates ( Table 1 ) [ 17 , [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] , [98] , [99] , [100] , [101] , [103] , [104] , [105] , [106] , [107] , [108] , [109] , [110] , [111] , [112] , [113] , [114] , [115] , [116] , [117] , [118] , [120] , …”

Section: Resultsmentioning

confidence: 99%

“…The immunogenicity outcomes varied between studies. Although the majority of studies/study subgroups (n = 29) reported similar antibody responses after ID compared to IM/SC immunisation [ 17 , 90 , 92 , 94 , [96] , [97] , [98] , [99] , 101 , 103 , [105] , [106] , [107] , [108] , [110] , [111] , [112] , [114] , [115] , [116] , [117] , [118] , [119] , [120] , [121] , 124 , 126 , 129 , 130 ], a considerable number of studies found inferior antibody responses in the ID group compared to IM (n = 15) [ 91 , 93 , 95 , 100 , 102 , 104 , 109 , 112 , 113 , 122 , 123 , 125 , 127 , 128 , 131 ]. Nine out of ten studies on haemodialysis patients showed potential for dose-sparing with ID immunisation [ 92 , [96] , [97] , [98] , 113 , 114 , 121 , 124 ].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Fractional dose of intradermal compared to intramuscular and subcutaneous vaccination - A systematic review and meta-analysis

Schnyder

Pijper

Garrido

et al. 2020

Travel Medicine and Infectious Disease

View full text Add to dashboard Cite

Background Vaccine supply shortages are of global concern. We hypothesise that intradermal (ID) immunisation as an alternative to standard routes might augment vaccine supply utilisation without loss of vaccine immunogenicity and efficacy. Methods We conducted a systematic review and meta-analysis searching Medline, Embase and Web of Science databases. Studies were included if: licensed, currently available vaccines were used; fractional dose of ID was compared to IM or SC immunisation; primary immunisation schedules were evaluated; immunogenicity, safety data and/or cost were reported. We calculated risk differences (RD). Studies were included in meta-analysis if: a pre-defined immune correlate of protection was assessed; WHO-recommend schedules and antigen doses were used in the control group; the same schedule was applied to both ID and control groups (PROSPERO registration no. CRD42020151725). Results The primary search yielded 5,873 articles, of which 156 articles were included; covering 12 vaccines. Non-inferiority of immunogenicity with 20–60% of antigen used with ID vaccines was demonstrated for influenza (H1N1: RD -0·01; 95% CI -0·02, 0·01; I 2 = 55%, H2N3: RD 0·00; 95% CI -0·01, 0·01; I 2 = 0%, B: RD -0·00; 95% CI -0·02, 0·01; I 2 = 72%), rabies (RD 0·00; 95% CI -0·02, 0·02; I 2 = 0%), and hepatitis B vaccines (RD -0·01; 95% CI -0·04, 0·02; I 2 = 20%). Clinical trials on the remaining vaccines yielded promising results, but are scarce. Conclusions There is potential for inoculum/antigen dose-reduction by using ID immunisation as compared to standard routes of administration for some vaccines (e.g. influenza, rabies). When suitable, vaccine trials should include an ID arm.

show abstract

Intradermal administration of viral vaccines

et al. 1998

View full text Add to dashboard Cite

Comparison of intradermal and intramuscular hepatitis B vaccination in university students

Cited by 17 publications

References 6 publications

The immune response to hepatitis B vaccine in humans: inheritance patterns in families.

The immune response to hepatitis B vaccine in humans: inheritance patterns in families.

Fractional dose of intradermal compared to intramuscular and subcutaneous vaccination - A systematic review and meta-analysis

Intradermal administration of viral vaccines

Contact Info

Product

Resources

About