HealthDay News — For intramuscular hepatitis B virus vaccine nonresponders, intradermal vaccine administration seems efficacious and safe, according to a study published in the Journal of Gastroenterology and Hepatology.

About 5% to 10% of people fail to develop a protective immune response to hepatitis B virus (HBV) vaccination, which has important implications for health care workers, families living in households with people that have HBV, and others who may be at increased risk of exposure to HBV.

So Or Kalchiem-Dekel, MD, from the Soroka University Medical Center in Israel, and colleagues designed a prospective case series to examine efficacy, safety, and durability of intradermal vaccine administration in those who have not responded well to intramuscular HBV vaccine. 

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The medical records of 4,007 heath care personnel who worked in the hospital between 1996 and 2006 were examined, and the researchers identified nonresponders who had an unsatisfactory level of hepatitis B surface antibody (HBsAb) after two courses of a three-dose intramuscular HBV vaccine.

They were vaccinated with three doses of 5 µg intradermal recombinant HBs antigen (HBsAg)-based vaccine. Data were included for 27 subjects, of whom 21 completed the study.

The researchers found that 70.3% of subjects had a satisfactory HBsAb level at 4 weeks after the last administered dose. At 24 weeks, sustained immune response was seen in 62.9% of subjects based on intention-to-treat analysis and 80.9% based on per-protocol analysis. No adverse events in response to vaccine administration were reported.

“Intradermal administration of HBV vaccine offers an efficient, safe, and durable option for intramuscular vaccine nonresponders, and represents a means to optimize utilization of the widespread HBsAg-based vaccine formulation,” the authors write.


  1. Kalchiem-Dekel O et al. J Gastroenterol Hepatol. 2015; doi:10.1111/jgh.13022.