Hepatitis B vaccine in medical staff of hemodialysis units: efficacy and subtype cross-protection

N Engl J Med. 1982 Dec 9;307(24):1481-6. doi: 10.1056/NEJM198212093072403.


We evaluated the efficacy of hepatitis B vaccine (Heptavax-B) containing only the ad subtype in a randomized, placebo-controlled, double-blind trial among 865 staff members of 43 hemodialysis units in the United States. Surface antibody developed in 92.6 per cent of the subjects after two doses of vaccine and in 96 per cent after the six-month booster. The incidence of infections with hepatitis B virus (with or without hepatitis) was 9.9 per cent in placebo recipients and 2.2 per cent in vaccine recipients (P less than 0.01). The two cases of hepatitis B among vaccine recipients did not occur in subjects in whom antibody had developed. In 81 per cent of the hepatitis events, the virus was of the ay subtype. The indicence of ay virus was 8.2 per cent among placebo recipients and 1.2 per cent among vaccine recipients (P less than 0.005). We conclude that these data confirm the efficacy of the vaccine and demonstrate subtype cross-protection.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antibody Formation
  • Clinical Trials as Topic
  • Cross Reactions
  • Double-Blind Method
  • Female
  • Hemodialysis Units, Hospital*
  • Hepatitis B / prevention & control*
  • Hepatitis B Antibodies / analysis
  • Hepatitis B virus / immunology*
  • Hospital Units*
  • Humans
  • Male
  • Occupational Diseases / prevention & control*
  • Personnel, Hospital*
  • Random Allocation
  • United States
  • Viral Vaccines / adverse effects
  • Viral Vaccines / immunology*


  • Hepatitis B Antibodies
  • Viral Vaccines