Accelerated schedule of hepatitis B vaccination in high-risk youth

Objective: To perform a feasibility and immunogenicity study of an accelerated schedule of hepatitis B immunization for high-risk youth. Methodology: High-risk adolescents attending a youth health centre and nearby youth refuges were immunized with Engerix-B recombinant vaccine, 20 μg intramuscularly, at 0,2 and 6 weeks. Serology was performed prior to immunization and 3 months after the third dose. Results: Forty-two subjects (27 female) aged 13-20 years entered the study. Two (4.8%), already hepatitis B virus (HBV) seropositive, were excluded. Thirty-six of 40 subjects had one or more risk factors for HBV. Participants were often elusive, needing multiple attempts to establish contact. Twenty (50%) of the 40 completed three immunizations and all 14 studied developed anti-hepatitis B surface titres of > 100mlU/mL (geometric mean titre 630 mIU/mL, 95% confidence intervals 309-1290). Conclusion: High-risk youth can be immunized against hepatitis B successfully using an accelerated schedule, but compliance is difficult.