PT  - JOURNAL ARTICLE
AU  - Van Herck, K
AU  - Leuridan, E
AU  - Van Damme, P
TI  - Schedules for hepatitis B vaccination of risk groups: balancing immunogenicity and compliance
AID  - 10.1136/sti.2006.022111
DP  - 2007 Oct 01
TA  - Sexually Transmitted Infections
PG  - 426--432
VI  - 83
IP  - 6
4099  - http://sti.bmj.com/content/83/6/426.short
4100  - http://sti.bmj.com/content/83/6/426.full
SO  - Sex Transm Infect2007 Oct 01; 83
AB  - Introduction: Vaccination is an important tool in hepatitis B prevention. However, several vaccine doses are required to induce long-term protection. Several at-risk groups have difficulties in adhering to the standard vaccination schedule. Objectives: This paper aims to review the use of accelerated hepatitis B vaccination schedules, in terms of immunogenicity and compliance. Results: Accelerated schedules (0.1.2.12 months) or super-accelerated schedules (0.7.21.360 days) have been shown to result in higher proportions of healthy vaccinees reaching anti-HBs antibody levels ⩾10 IU/l more rapidly. A fourth completing dose is required to lift antibody levels to an equal height, as does a standard (0.1.6 months) schedule. Accelerated schedules do also increase the uptake of hepatitis B vaccine, that is the proportion of vaccinees who receive three doses. However, completing the schedule with a fourth dose is usually more difficult than completing a standard 0.1.6-month schedule. Several additional tools can help to increase the compliance (eg, reminder systems, outreach services and incentive schemes). Conclusion: For rapid seroconversion and almost immediate protection in the short term, a (super)accelerated schedule could be used in at-risk groups. As long-term protection data with these (super) accelerated schedules have not been documented yet, a fourth dose at month 12 is still required. A shortened schedule (0.1.4 months) might be an alternative worth considering compared with the standard 0.1.6, as it convenes to internationally accepted minimum dose intervals and offers earlier protection. There is a clear need to study the long-term protection and effectiveness of the primary part of (super)accelerated schedules.