Biomaterial Database

Cost effectiveness of intradermal vs. subcutaneous hepatitis B vaccination for the mentally handicapped. 1991

J Hayashi, and K Nakashima, and A Noguchi, and M Morofuji, and S Kashiwagi

Department of General Medicine, Kyushu University Hospital, Fukuoka, Japan.

The currently available hepatitis B vaccine is being under utilized for reasons of cost and availability. To address this problem, we performed a recombinant hepatitis B vaccine trial comparing the currently recommended regimen of 10 micrograms subcutaneously (sc) in months 0, 1 and 6 with a more economical regimen of 2 micrograms intradermally (ID) in months 0, 1, 6. This trial assessed the immunogenicity of both regimens in 95 seronegative mentally handicapped patients. Forty four patients (aged 19-55 years, mean age 29.1 years) were vaccinated subcutaneously with recombinant vaccine and 51 (aged 19-52 years, mean age 28.3 years) were given intradermally. We found no significant difference in seroconversion between the subcutaneous group (93.2%) and the intradermal group (96.1%) 12 months after the first vaccination, but the antibody titres were lower in the intradermal group. We feel therefore that the dose should be increased slightly or further injections should be given. As the cost of intradermal vaccination is considerably lower than when using the subcutaneous route, underprivileged patients in institutions could the more readily be immunized against hepatitis B infection.

UI	MeSH Term	Description	Entries
D007271	Injections, Intradermal	The forcing into the skin of liquid medication, nutrient, or other fluid through a hollow needle, piercing the top skin layer.	Intradermal Injections,Injection, Intradermal,Intradermal Injection
D007279	Injections, Subcutaneous	Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin.	Subcutaneous Injections,Injection, Subcutaneous,Subcutaneous Injection
D007564	Japan	A country in eastern Asia, island chain between the North Pacific Ocean and the Sea of Japan, east of the Korean Peninsula. The capital is Tokyo.	Bonin Islands
D008297	Male		Males
D008607	Intellectual Disability	Subnormal intellectual functioning which originates during the developmental period. This has multiple potential etiologies, including genetic defects and perinatal insults. Intelligence quotient (IQ) scores are commonly used to determine whether an individual has an intellectual disability. IQ scores between 70 and 79 are in the borderline range. Scores below 67 are in the disabled range. (from Joynt, Clinical Neurology, 1992, Ch55, p28)	Disability, Intellectual,Idiocy,Mental Retardation,Retardation, Mental,Deficiency, Mental,Intellectual Development Disorder,Mental Deficiency,Mental Retardation, Psychosocial,Deficiencies, Mental,Development Disorder, Intellectual,Development Disorders, Intellectual,Disabilities, Intellectual,Disorder, Intellectual Development,Disorders, Intellectual Development,Intellectual Development Disorders,Intellectual Disabilities,Mental Deficiencies,Mental Retardations, Psychosocial,Psychosocial Mental Retardation,Psychosocial Mental Retardations,Retardation, Psychosocial Mental,Retardations, Psychosocial Mental
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D012112	Residential Facilities	Long-term care facilities which provide supervision and assistance in activities of daily living with medical and nursing services when required.	Facilities, Residential,Facility, Residential,Residential Facility
D003362	Cost-Benefit Analysis	A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes.	Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D005260	Female		Females
D006509	Hepatitis B	INFLAMMATION of the LIVER in humans caused by a member of the ORTHOHEPADNAVIRUS genus, HEPATITIS B VIRUS. It is primarily transmitted by parenteral exposure, such as transfusion of contaminated blood or blood products, but can also be transmitted via sexual or intimate personal contact.	Hepatitis B Virus Infection