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Clarification: Vol. 43, Nos. 51 & 52
The notice to readers "Recommended Childhood Immunization
Schedule -- United States, January 1995" (pages 959-960) stated
that
infants born to hepatitis B surface antigen (HBsAg)-positive
mothers should receive immunoprophylaxis with 0.5 mL of hepatitis
B immune globulin (HBIG) and 0.5 mL of hepatitis B vaccine
administered at separate sites. Hepatitis B vaccines licensed in
the United States are produced by Merck and Co., Inc. (Rahway, New
Jersey), and SmithKline Beecham (Philadelphia) and are available in
various concentrations. The recommended dose of hepatitis B vaccine
for infants varies by manufacturer and HBsAg status of the mother
Table_1. Merck and Co., Inc., recommends 2.5 ug of Recombivax
HB
(registered) for infants of HBsAg-negative mothers and 5.0 ug for
infants of HBsAg-positive mothers; SmithKline Beecham recommends 10
ug of Engerix-B (registered) regardless of the mother's HBsAg
status. Providers should know the HBsAg status of an infant's
mother and consult the product package insert for the recommended
vaccine dose.
Providers also should be aware that the Food and Drug
Administration recently lowered the age-appropriate dose of
Engerix-B (registered) from 20 ug to 10 ug for adolescents 11-19
years of age Table_1 (1).
Reference
Smithkline Beecham Pharmaceuticals. Brief summary of prescribing
information: Engerix-B (registered) {Package insert}. Philadelphia:
Smithkline Beecham Pharmaceuticals, 1995.
Table_1
Note:
To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.
TABLE 1. Recommended doses of currently licensed hepatitis B vaccines, by
age or risk group
==========================================================================
Group Recombivax HB{R} * Engerix-B{R} +
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Infants of HBsAg-negative mothers 2.5 ug 10.0 ug
Infants of HBsAg-positive mothers 5.0 ug 10.0 ug
Children
(Aged 1--10 years) 2.5 ug 10.0 ug
Adolescents
(Aged 11--19 years) 5.0 ug 10.0 ug
Adults
(Aged >=20 years) 10.0 ug 20.0 ug
Dialysis patients and other
immunocompromised persons 40.0 ug 40.0 ug
-------------------------------------------------------------------------
* Produced by Merck and Co. Inc. (Rahway, New Jersey).
+ Produced by SmithKline Beecham (Philadelphia).
=========================================================================
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