A significantly higher prevalence of a protective concentration of anti-HBs was achieved at 1 and 2 months among 132 healthy medical students who received an accelerated vaccination schedule with a recombinant hepatitis B vaccine (Engerix-B) than among 120 medical students who received a conventional regimen. With the accelerated schedule, however, 60% students at 1 month and 27% at 2 months were still unprotected (anti-HBs titre less than 10.0 IU/l). Additional passive immunisation should therefore continue to be offered if the accelerated schedule is adopted for post-exposure prophylaxis.
PIP: In 1989-1990, researchers placed healthy 1st year medical students either into the standard vaccine scheduled group (120) or the accelerated vaccine scheduled group (132) to compare early hepatitis B antibody (anti-HBs) titers to determine if accelerated postexposure prophylaxis without hepatitis B immune globulin (HBIG) can induce as effective protection as conventional postexposure prophylaxis with HBIG. The students attended the Liverpool Medical School in Liverpool, England. Fewer students in the accelerated group used oral contraceptives and smoked cigarettes than the conventional group (p.05). Among students who were on the accelerated schedule, many more Asian than European students and many more students with a body mass index 20 developed anti-Hbs 10 IU/1 at the 1st month (p.05). Other than the differences at 1 month, the differences did not affect anti-Hbs titers. considerably more students in the accelerated group attained anti-HBs titers 10 IU/1 at 1 month (p.001) and 2 months (p.05) than those in the standard group. Nevertheless 60% of the students in the accelerated group at 1 month and 27% at 2 months were still susceptible to hepatitis B infection since they had anti-HBs titers -or= 10 IU/1. Students on the accelerated schedule experienced similar side effects at a similar rate as those on the conventional schedule. The reactions usually lasted for 24 hours and included pain and/or redness and/or swelling and headache and/or fever. In conclusion, health practitioners should continue to suggest passive immunization with HBIG in concert with an accelerated hepatitis B vaccine schedule.