PEDIATRICS Vol. 108 No. 6 December 2001, pp. 1392
Prevention of Hepatitis B in Adolescents
To the Editor—
For prevention of hepatitis B in adolescents using Recombivax (Merck and Co Inc, West Point, PA), the Food and Drug Administration has approved the use of a 2-dose 10-µg regimen as an alternative to the 3-dose 5-µg regimen in persons 11 to 15 years of age. A recent commentary by Dr Gregory Poland called "Adolescent Hepatitis B Immunization: Making It Simpler"1 stated a preference for using the 2-dose 10-µg per dose regimen. Although Dr Poland makes a number of salient arguments to support his position, one important reason he cites is that the vaccine purchase price to complete the immunization series is less for the 2-dose regimen. However, in both the public and private sectors the purchase price of the 10-µg vials is at least twofold greater than the 5-µg vials. For example, in the public sector the cost of Recombivax is $9.00 for a 5-µg dose versus $23.25 for a 10-µg dose. Thus, the total purchase price of the vaccine to complete the immunization series in 11- to 15-year-old persons is $27.00 for the 3-dose 5-µg per dose series versus $46.50 for the 2-dose 10-µg per dose series. Even when including the additional average administration fee, which is $8.77 in the United States according to data from the Centers for Disease Control and Prevention, the cost of the 2-dose 10-µg series remains higher. Because of these cost differences, the Committee on Infectious Diseases of the AAP believes that the decision to use either the 2-dose or the 3-dose regimen is best made by the practitioner on the basis of economic and social factors for the particular individual being immunized.
AAP Committee on Infectious Diseases, 2000–2001
Jon S. Abramson, MD, Chairperson
Carol J. Baker, MD
Margaret C. Fisher, MD
Michael A. Gerber, MD
H. Cody Meissner, MD
Dennis L. Murray, MD
Gary D. Overturf, MD
Charles G. Prober, MD
Margaret B. Rennels, MD
Thomas N. Saari, MD
Leonard B. Weiner, MD
Richard J. Whitley, MD
Ex-Officio
Larry K. Pickering, MD
Editor, Red Book
PEDIATRICS (ISSN 1098-4275). ©2001 by the American Academy of Pediatrics
