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Low Dose Intradermal Vaccination Is Superior to High Dose Intramuscular Vaccination for Hepatitis B in Unresponsive Hemodialysis Patients
Authors:Hasan Micozkadioglu  Aysegul Zumrutdal  Dilek Torun  Siren Sezer  Fatma Nurhan Ozdemir  Mehmet Haberal
Affiliation:1. Department of Nephrology, Ba?kent University Faculty of Medicine, Hospital of Adana, Adana, Turkeyhasanmicoz@hotmail.com;3. Department of Nephrology, Ba?kent University Faculty of Medicine, Hospital of Adana, Adana, Turkey;4. Department of General Surgery, Ba?kent University Faculty of Medicine, Hospital of Adana, Adana, Turkey
Abstract:
After two intramuscular (IM) vaccination protocols (40 μg at 0, 1, 2, and 6 months), patients who were unresponsive to hepatitis B vaccination were collected from three HD centers. The aim of this study was to compare the effectiveness of intradermal (ID) and repeated IM vaccination protocols. Thirty-three of 639 HD patients were found to be unresponsive. Patients were randomly assigned into two groups: one to receive 80 μg ID and the other 160 μg IM vaccination protocol. Both ID (p?=?0.000) and IM (p?=?0.03) groups disclosed statistically significant seroconversion rates six months after the last vaccination dose. The seroconversion rate was 94.1% in the ID and 50% in the IM groups—showing a significant improvement in the ID group (p?=?0.011). A low-dose ID is superior to standard IM vaccination protocol and also more cost-effective in unresponsive HD patients.
Keywords:hemodialysis  hepatitis B  unresponsiveness
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