Adherence and efficacy of the 0 - 7 - 21-day versus the 0 - 1 - 6-month hepatitis B vaccination schedules among people who use drugs: a two-year randomized controlled trial.
Xianbin Hou, Ning Li, Hailan Zhang et al.
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In 30 seconds
This two-year randomized controlled trial compared hepatitis B vaccination schedules among 1261 HBV-susceptible people who use drugs in detoxification centers and methadone clinics in Xi'an, China. Third-dose coverage was higher with doses at days 0, 7, and 21 than with doses at months 0, 1, and 6 (74.40% vs 51.58%, p < 0.001). Among participants completing all doses, however, anti-HBs positivity was higher with the 0-1-6-month schedule at each reported follow-up. HBV infection incidence was similar between schedules.
Key findings
- Third-dose coverage was 74.40% with the 0-7-21-day schedule versus 51.58% with the 0-1-6-month schedule (p < 0.001).
- Among three-dose completers, anti-HBs positivity at months 7, 15, and 22 was 90.71%, 76.82%, and 67.35% with the 0-1-6-month schedule, versus 74.23%, 49.40%, and 40.95% with the accelerated schedule (all p < 0.001).
- HBV infection incidence was similar between schedules; incidence differed significantly between vaccinees and non-vaccinees (p = 0.018).
Why it matters
The findings illustrate a practical trade-off in this population: an accelerated schedule was associated with better completion, while the conventional schedule produced stronger and more persistent anti-HBs responses among completers. Considering both uptake and immune response may help inform schedule selection across different service settings, although the trial found similar infection incidence between schedules.
What to keep in mind
Anti-HBs comparisons were reported among participants who completed all three doses, rather than all randomized participants; infection incidence was similar between schedules.