Comparison of intradermal route and dose of Hepatitis B vaccine administration in chronic dialysis patients: A pilot study

We aimed to study the seroconversion rate in two arms of intradermal (ID) route: low dose with high-frequency and high dose with low-frequency hepatitis B (HB) vaccination in dialysis patients. A total of 56 patients, on either hemodialysis or peritoneal dialysis, were included. Patients were enrolled and randomized into two groups. The first group was immunized through the ID route and received weekly 10 μg of vaccine at 0, 1, 2, 3, 4, 5, 6, and 7 weeks (low-dose with high frequency). The second group was immunized through the ID route and received two doses of 40 μg at one-month interval (high dose with low frequency). Anti-HBs antibody titers were measured at one month and one month after completion of the vaccination, i.e., at three months in each group. At one month, each group had received 40 μg of vaccine. The seroconversion rate was 28.57% in each group. At one month after completion of vaccination, seroconversion rate in low-dose ID and high-dose ID was 60% and 58.33%, respectively (P = 0.911) at 80 μgm of total vaccine dose. The overall "good" responders in low-dose versus high-dose ID route were 30% and 50%, respectively (P = 0.179). However, among responders, anti-HBs antibody titers ≥100 mIU/mL in low-dose and high-dose ID route were 50% and 85.7%, respectively (P = 0.049). The rate of seroconversion is comparable in both low dose with high-frequency and high dose with low-frequency ID route.