Intradermal Inoculation With Heptavax-B: Immune Response and Histologic Evaluation of Injection Sites

Jessica A. Clarke, F. Blaine Hollinger, Ernest Lewis, Liisa A. Russell, Claramae H. Miller, Art Huntley, Neil M. Flynn

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


The high cost of hepatitis B vaccine has limited its widespread use. Low-dose, intradermal injections of vaccine represent one option for reducing the cost. In this study, 92 nonimmune medical students were given three 0.1-mL intradermal injections of Heptavax-B containing 2 μg of hepatitis B surface antigen (HBsAg) at 0,1, and 6 months. By 6 months, 90% of the subjects had developed protective levels of antibody to HBsAg (≥10 mlU/mL). Follow-up at 1 year showed a geometric mean concentration of antibodies to HBsAg of 396 mlU/mL for the group, and 95% had levels of antibody to HBsAg greater than or equal to 10 mlU/mL. A level of antibody to HBsAg of greater than 100 mlU/mL also was observed in more than 75% of subjects. Side effects included induration of the inoculation site in 18% at 6 months, which disappeared by 12 months, and macules that persisted at 1 year in 63%. The administration of hepatitis B vaccine intradermally is an attractive, low-cost alternative in the United States, where universal vaccination of preschool children or adolescents is being contemplated, and where booster doses are being considered.

Original languageEnglish (US)
Pages (from-to)2567-2571
Number of pages5
JournalJAMA: The Journal of the American Medical Association
Issue number18
StatePublished - Nov 10 1989
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


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