The immunogenicity of low dose intra dermal recombinant hepatitis b vaccination, compared to standard dose

, Hepatitis B virus (HBV) infection is still world wide health problem. The high cost of HB vaccine is still a serious economical constraint to the prevention of the disease. The effectiveness of the low dose intradermal (LDI) methods of HB vaccination is still in debate. This study was intended to assess the proportion of Anti-HBs seroconversion produced by low dose intradermal (LDI) recombinant Hepatitis B (HB) vaccination, compared to standard dose intramuscular (SD). The study used a randomized controlled trial. Healthy personnel of Dr.Kariadi General Hospital and senior medical student of Diponegoro University in Semarang, who seronegative to HB virus and fulfilled the eligibility criteria. Total 258 study subjects were randomized divided into two groups: LDI (experimental) group and SD (control) group. They received 3 times injection of recombinant HB vaccine (Bimmugen R/) at 0, 1 and 6 months. In LDI group they received 0.1 mL (Zug HBsAg) of vaccine injected intradermally and in SD group they received 0.5 mL (10 ug HBsAg) of vaccine injected intramuscularly. The main outcome was the Anti-HBs seroconversion (Anti-HBs > 10 mIU/mL), measured at 1 month after the last injection of HB vaccine. It was revealed that 249 (96.5%) subjects were completely followed study protocol, consisted of 125 in LDI group and 124 in SD group. The proportion of Anti-HBs seroconversion in LDI group was 96% (95% CI: 93-99%) and in SD group was 98.4% (95% CI: 96-100%). Comparison of the proportion of Anti-HBs seroconversion between two groups were not significantly different (p = 0.23). It was also concluded that low dose intradermal recombinant HB vaccination produced the Anti-I-113s seroconversion equal or comparable to those produced by standard dose intramuscular. Suggestion: Low dose intradermal recombinant HB vaccination, which is relatively low cost and easy to conduct, may be feasible and useful as an alternative method for mass FIB immunization program to adult people. This method may increase the coverage of immunization and may provide community herd immunity to Hepatitis B virus. Keywords: low dose intradermal â recombinant Hepatitis B vaccination â randomized controlled trial â comparison â Anti-HBs seroconversion