IMMUNIZATION WITH HIGH-DOSE INTRADERMAL RECOMBINANT HEPATITIS-B VACCINE IN HEALTH-CARE WORKERS WHO FAILED TO RESPOND TO INTRAMUSCULAR VACCINATION

OBJECTIVE: To achieve immunity to hepatitis B in healthcare workers wh o 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 Connectic ut. 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 i mmunity 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 intram uscular vaccine. Further studies, including randomized comparisons wit h intramuscular vaccine as well as studies of cell-mediated immunity, appear warranted.