This was an observational study of non-responsive HCWs who were referred to Stockport Specialist Immunisation Clinic (SSIC) between 1st January 2003 and 31st May 2006. Anti-HBs titres were determined 4-6 weeks after each intradermal recombinant vaccine (IDRV). Median anti-HBs titres were compared using the exact Wilcoxon rank sum test. In total, 23 eligible non-responding HCWs were identified. Protective anti-HBs titres (≥10 mIU/ml) were induced in the majority of non-responders [21/23 (91.3%)] following two doses of IDRVs. HCWs who responded to the 1st IDRV with anti-HBs levels ≥ 10 mIU/ml were significantly younger and received their 1st IDRV more than six months after the last IM dose. Two HCWs (41 and 45 year old females) anti-HBs titres remained below 10 mIU/ml even after a 3rd dose. Anti-HBs titres were available for 40% (9/23) of the HCWs six or more months after the last maximum anti-HBs titres were achieved. None of the nine HC-Ws anti-HBs titres declined to less than 10 mIU/ml six or more months after the last maximum anti-HBs titres were achieved. However, a larger study with long-term follow-up is needed to determine the duration of protection following IDRV. HCWs with anti-HBs titres <10 mIU/ml after two full courses of intramuscular recombinant vaccine (IMRV) should be offered two doses of IDRVs followed by assessment of anti-HBs titres one to four months after the second dose in order to identify persistent non-responders. No significant adverse events were noted with IDRV being well tolerated and acceptable to HCWs.
- Healthcare workers
- Hepatitis B
- Hepatitis B surface antibody litres
- Hepatitis B surfaceantigen
- Recombinant vaccine