Immune Response of Intradermal Hepatitis B Vaccination
at Lower Dose versus Intramuscular Vaccination at Double
Standard Dose in Predialytic Chronic Renal Failure Patients
WANIDA SOMBOONSILP, MD*, SOMCHAI EIAM-ONG, MD**,
KRIANG TUNGSANGA, MD**, THAW EESAK TIRA WATANAPONG, PhD***
Affiliation : * Nephrology Unit, Internal Medicine Group, Cluster of Tertiary Care, Chaoprayayomraj Regional Hospital, Ministry
of Public Health, Suphanburi 72000,
** Division of Nephrology, Department of Medicine,
*** Immunology Unit, Department of Microbiology, Faculty of Medicine, Chulalongkom University, Bangkok 10330,
Thailand.
AbstractThe immune responses to hepatitis B vaccine were studied in 2 groups of predialytic chronic
renal failure patients who had negative results of hepatitis B surface antigen (HBsAg), hepatitis B sur
face antibody (anti-HBs) and hepatitis B core antibody (anti HBc). In the intradermal group, vaccine at
the dose of 0.1 ml, 2 J..lg, was intradermally administered at 5 positions. In the intramuscular group, the
vaccine at the dose of 1.0 ml, 20 J..lg, was intramuscularly given at 2 positions and, thus, was a double
standard dose. Both groups received 4 vaccinations at month 0, 1, 2, and 6 (MO, Ml, M2, and M6).
The results showed that there were no significant differences in the results of seroconversion rates,
defined as having anti HBs levels above 10 miU/ml, between the intradermal (ID) and intramuscular
(IM) groups at Ml, M2, M6, and M7. In patients with positive seroconversion results at M7, the num
bers of patients in the good and excellent subgroups, having HBs Ab levels ranged 10-999 and above
1,000 miU/ml respectively, showed no difference between both routes. The body weight and serocon
version rates at M2 and M6 were the factors which had a positive influence on the seroconversion rates
of intradermal hepatitis B vaccination. In conclusion, intradermal hepatitis B vaccination at a lower
dose could provide comparable satisfactory immune response with the intramuscular route at double
the standard dose.
Keywords : Hepatitis B Vaccination, Intradermal Route, Intramuscular Route
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