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Pediatrics. 2010 Mar;125(3):e508-12. doi: 10.1542/peds.2009-1592. Epub 2010 Feb 8.

Effect of needle length when immunizing obese adolescents with hepatitis B vaccine.

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  • 1MSEd, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin St, Suite 1710.00, Houston, TX 77030, USA.



Several studies have noted that obese adolescents and adults achieve lower titers of antibody in response to vaccines such as hepatitis B virus (HBV) vaccine. The objective of this study was to determine whether use of a longer (1.5-in) rather than a standard (1-in) needle to penetrate the thicker deltoid fat pad among obese youth would result in higher antibody titers after immunization against HBV.


Obese adolescents from a large metropolitan area who had not previously received the HBV vaccine were randomly assigned to be immunized with HBV vaccine by using either a 1-inch or a 1.5-inch needle.


Those who were immunized with a 1.5-inch needle achieved significantly higher antibody titers to hepatitis B surface antigen (median titers: 1-inch = 189.8 mIU/mL, 1.5-inch = 345.4 mIU/mL; P = .03).


This finding supports the hypothesis that needle length accounts for a significant portion of the discrepancy in immune response to HBV vaccine that is seen among those with obesity.

[PubMed - indexed for MEDLINE]
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