Table 1.
Summary of efficacy and dose-sparing effect of ID vaccination, as compared with IM or SC vaccination, in infants and children.
| ID injection |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Vaccine | Country | Year | Age | No. of subjects | Method | Dose | Comparison | Efficacy* | Dose sparing | Reference |
| Trivalent inactivated influenza | China | 2007 | 3 to <18 years | 112 | Mantoux | 3 μg# | 15 μg IM | Comparable Seroprotection rates, fold increase in HAI GMT (95% CI) H1N1; 98% vs. 98%, 12.9 (7.9–21.4) vs. 11.1 (7.2–17.1) H3N2; 100% vs. 100%, 2.6 (2.1–3.4) vs. 4.5 (3.4–5.9)§ B/Shanghai; 96% vs. 93%, 4.3 (3.2–5.8) vs. 4.4 (3.3–5.8) |
Yes | 34 |
| Japan | 2008 | 6–12 months | 34 | Mantoux | 3 μg | 3 μg SC | Superior Positive titer rate, HAI titer ≥ 10 No. (%) H1N1; 14 (93.3) vs. 8 (47.1)§ H3N2; 14 (93.3) vs. 14 (82.3) B/Shanghai; 11 (73.3) vs. 6 (35.3)§ |
N/A | 37 | |
| China | 2009 | 2–3 months | 123 | Mantoux | 3 μg | 7.5 μg IM | Comparable Fold increase in HAI GMT (95% CI) H1N1; 1.21 (1.02–1.43) vs. 1.13 (0.96–1.34) H3N2; 1.26 (1.07–1.46) vs. 1.26 (1.06–1.50) B/Malaysia; 1.15 (0.99–1.32) vs. 1.07 (0.94–1.22) |
Yes | 35 | |
| Italy | 2011 | 3–11 years | 112 | Microneedle device | 9 μg, 15 μg | 15 μg IM (with adjuvant) | Superior Seroprotection rates, fold increase in HAI GMT** H1N1; 92.1% vs. 94.6% vs. 86.5%, 7.9 vs. 10.9 vs. 14.9 H3N2; 97.4% vs. 97.3% vs. 94.6%, 3.2 vs. 4.9 vs. 3.6 B/Brisbane; 55.3% vs. 62.2% vs. 32.4%§, 2.4 vs. 8.6 vs. 1.9§ |
Yes | 36 | |
| Inactivated poliovirus | Oman | 2010 | 2, 4, 6 months¶ | 373 | Needle-free jet injector | 0.1 mL | 0.5 mL IM | Similar seroconversion rates but lower titers Seroconversion rates, median titers (95% CI) Type1; 97.3% vs. 100%, 228 (144–287) vs. 724 (575–912)§ Type 2; 95.7% vs. 100%§, 287 (228–456) vs. 1149 (912–1,149)§ Type 3; 97.9% vs. 100%, 362 (287–456) vs. ≥1,448 (≥1,448-≥1,448)§ |
Yes | 41 |
| Cuba | 2010 | 6, 10, 14 weeks | 364 | Needle-free jet injector | 0.1 mL | 0.5 mL IM | Inferior Seroconversion rates, median titers (95% CI) Type1; 52.9% vs. 89.3%§, 19 (19–22) vs. 85 (54–99)§ Type 2; 85.0% vs. 95.5%§, 45 (45–54) vs. 214 (178–295)§ Type 3; 69.0% vs. 98.9%§, 32 (24–45) vs. 295 (214–355)§ |
Yes | 47 | |
| Philippines | 2012 | 6, 10, 14 weeks, 15–18 months | 224 | Mantoux | 0.1 mL | 0.5 mL IM | Similar seroprotection rates but lower titers Seroprotective rates, GMT (95% CI) Type 1; 100% vs. 100%, 2,833 (2,392–3,356) vs. 6,666 (5,613–7,916) Type 2; 100% vs. 100%, 3,210 (2,672–3,857) vs. 6,522 (5,540–7,678) Type 3; 100% vs. 100%, 4,498 (3,608–5,607) vs. 11,952 (10,046–14,220) |
Yes | 46 | |
| India | 2012 | 6–9 months | 869 | Needle-free jet injector | 0.1 mL | 0.5 mL IM | Inferior Seroprevalence (95% CI), median titers (95% CI) Type 1; 100% (98–100) vs. 100% (98–100), ≥1,448 (≥1,448-≥1,448) vs. ≥1,448 (≥1,448-≥1,448§ Type 2; 89% (83–93) vs. 99% (97–100)§, 724 (455–910) vs. ≥1,448 (1,176-≥1,448)§ Type 3; 70% (62–76) vs. 95% (90–97)§, 202 (28–724) vs. 455 (181–910)§ |
No | 48 | |
| Cuba | 2013 | 4 and 8 months | 310 | Needle-free jet injector | 0.1 mL | 0.5 mL IM | Inferior Seroconversion rates, median titers (95% CI) Type1; 93.6% vs. 100%§, 450 (357–566) vs. ≥1,448 (≥1,448-≥1,448)§ Type 2; 98.1% vs. 100%, 898 (713-≥1,448) vs. ≥1,448 (≥1,448-≥1,448)§ Type 3; 93.0% vs. 99.3%§, 71 (36–113) vs. 898 (566-≥1,448)§ |
Yes | 51 | |
| Cuba | 2015 | 12–20 months | 728 | Needle-free jet injector | 0.1 mL | 0.5 mL IM | Inferior Seroprevalence, median titers (95% CI) Type 1; 98% vs. 98.6%, 1,423 (1,130–1,423) vs. 4,499 (3,573–5664) Type 2; 98.7% vs. 100%, 1,130 (898–1,130) vs. 2,839 (2,255–3,573) Type 3; 95.4% vs. 99.3%, 1,423 (898–1,791) vs. 4,499 (3,573–4,499) |
N/A | 49 | |
| Bangladesh | 2015 | 6, 14 weeks | 308 | Microneedle device | 0.1 mL | 0.5 mL IM | Inferior Seroconversion rates Type 1; 87.5% vs. 94.9% Type 2; 80.9% vs. 91% Type 3; 88.8% vs. 97.4% |
N/A | 50 | |
| Rabies virus | Thailand | 1998 | 5–12 years | 118 | Mantoux | 0.1 mL | 0.5 mL IM | Similar seroprotection rates but lower titers Seroprotection rates, GMT (95% CI) 100% vs. 98.3%, 1.6 (1.2–2.0) vs. 3.5 (2.5–4.8)§ |
Yes | 60 |
| Thailand | 2009 | 12–18 months | 177 | Mantoux | 0.1 mL | 0.5 mL, 1 mL IM | Similar seroprotection rates but lower titers Seroprotection rates, GMC (95% CI)***100% vs. 100% vs. 100% vs. 100%, 13 (8–20), 25 (16–38), 161 (103–251), 190 (121–299) |
Yes | 61 | |
| Hepatitis B virus | United States | 1994 | Neonates | 173 | Mantoux | 2 μg | 2 μg, 10 μg IM | Inferior Seroprotection rates, GMC****91% vs. 97% vs. 100%§, 312 vs. 317 vs. 2,248§ |
No | 65 |
| Turkey | 1998 | Neonates, 3–6 years | 367 | Mantoux | 2 μg | 10 μg IM | Similar seroprotection rates but lower titers Seroprotection rates, GMT Neonates; 94% vs. 98%, 621 vs. 935 Children; 100% vs. 98%, 804 vs. 1,393 |
Yes | 66 | |
| Hepatitis A virus | Thailand | 2005 | 8–12 years | 75 | Mantoux | 0.1 mL | 0.25 mL IM | Similar seroprotection rates but lower titers Seroprotection rates, GMT (95% CI)100% vs. 100%, 542 (390–753) vs. 834 (664–1047) |
Yes | 69 |
#
Amount of hemagglutinin antigen per strain in influenza vaccine
¶
Multiple ages in inactivated poliovirus vaccine category indicate multiple vaccinations at each time point for the same subjects
*
ID vaccination vs. the comparison (IM or SC)
**
ID 9 μg vs. ID 15 μg vs. IM
***
ID 2 doses vs. ID 3 doses vs. 0.5 mL IM vs. 1 mL IM
****
ID vs. 2 μg IM vs. 10 μg IM
§
Statistically significant
Abbreviations: ID, intradermal; IM, intramuscular; SC, subcutaneous; HAI, hemaggulutination inhibition; GMT, geometric mean titer; GMC, geometric mean concentration; CI, confidence interval; N/A, not available