Low response to intradermal hepatitis B vaccination in incident hemodialysis patients

Baixa resposta da vacinação intradérmica contra hepatite B em pacientes incidentes em hemodiálise

Renal insufficiency; chronic; Renal dialysis; Vaccination; Hepatitis B; virus

Insuficiência renal crônica; Diálise renal; Vacinação; Vírus da Hepate B

LETTERS

Low response to intradermal hepatitis B vaccination in incident hemodialysis patients

Baixa resposta da vacinação intradérmica contra hepatite B em pacientes incidentes em hemodiálise

Carlos Abaeté de los Santos; Regina H Medeiros; Ana Elizabeth PL Figueiredo; Carlos Eduardo Polide-Figueiredo; Domingos Otávio d'Avila; Jaqueline Antonio Pacheco; Carlos Abaeté de los Santos

Faculdade de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul (PUC/RS)

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ABSTRACT

Keywords: Renal insufficiency, chronic. Renal dialysis. Vaccination. Hepatitis B. virus.

RESUMO

Palavras-chave: Insuficiência renal crônica. Diálise renal. Vacinação. Vírus da Hepate B.

DEAR EDITOR,

We thank Prof. Alavian for his interest in our paper. The preferential route for hepatitis B (HB) vaccine administration remains controversial in hemodialysis (HD) patients. Our study aiming to compare intramuscular (IM) or intradermal (ID) inoculations was discontinued six months after starting, due to a Safety Monitoring Committee recommendation, since IM vaccination converted 62.3% of the patients, whereas the ID only 13.3%. These results would not allow ethically crossing the groups as proposed. Besides, the aim was to include only naïve patients. However, of those eight patients who did not respond to ID vaccine, seven were submitted to IM injections: three achieved adequate anti-HB levels and four did not. As emphasized in the text, one of the possible causes to the unresponsiveness was the presence of associated inflammation.¹ The vaccine dose applied (in micrograms!) may also have been one of the reasons.

Submitted on: 29/07/2011

Accepted on: 02/08/2011

The authors report no conflict of interest.

• 1. Medeiros RH, Figueiredo AE, Poli-de-Figueiredo CE, dAvila DO, de los Santos CA. Low response to intradermal hepatitis B vaccination in incident hemodialysis patients. J Bras Nefrol 2011;33:45-:49.

Publication Dates

• Publication in this collection
  28 Oct 2011
• Date of issue
  Sept 2011

History

• Accepted
  02 Aug 2011
• Received
  29 July 2011