Site of Injection and Response to Hepatitis B Vaccine

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Abstract
To the Editor: Early clinical trials indicated a high level of immunogenicity for the hepatitis B vaccine manufactured by Merck Sharp and Dohme.1 , 2 However, some subsequent studies have demonstrated response rates as low as 68 per cent in normal adults.3 , 4 Recent retrospective surveys by the Centers for Disease Control and the vaccine manufacturer have suggested that the anatomical site of injection may be an important factor in explaining a poor antibody response. In those surveys, programs giving vaccinations in the buttock had considerably lower response rates than programs giving vaccinations in the arm (deltoid muscle). Among 20 hemodialysis centers that . . .

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