High-Dose Intra-Dermal Hepatitis B Vaccine in a Liver Transplant Patient Who Failed Prior Intramuscular Vaccination: A Brief Case Report

Hepatitis B virus (HBV) chronic infection represents a significant cause of morbidity and mortality worldwide. While traditional intramuscular (IM) HBV vaccination is an excellent method for robust and sustained seroconversion in healthy individuals, its efficacy in chronic liver disease is sub-optimal and scant data exists in the post-liver transplant state. Importantly, HBV complications are even more severe in these same immunocompromised populations. Intra-dermal (ID) vaccination has shown initial promise as a successful alternative to achieving HBV seroconversion in patients refractory to standard vaccination protocols. Herein is a case report of a 61 year-old female who underwent liver transplantation for chronic HBV infection and achieved HBsAg seroconversion with a robust HSsAb titer with ID vaccination after having failed both standard and double dose IM vaccination.