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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

  1. 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} +
--------------------------------------------------------------------------
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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