CLARIFICATION: CHANGE IN RECOMMENDED DOSE OF ENGERIX-B FOR ADOLESCENTS

Abstract

The commentary entitled "The Recommended Childhood Immunization Schedule of the United States"1 that appeared in the January 1995 issue of Pediatrics 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 & Co and SmithKline Beecham Pharmaceuticals, and are available in various concentrations. The recommended infant dose of hepatitis B vaccine varies by manufacturer and HBsAg status of the mother (see Table). Merck & Co recommends 2.5 µg of Recombivax HB for infants of HBsAg-negative mothers and 5.0 µg for infants of HBsAg-positive mothers; SmithKline Beecham recommends 10 µg of Engerix-B 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 should also be aware that the Food and Drug Administration has recently lowered the age-appropriate dose of Engerix B from 20 µg to 10 µg for adolescents 11 to 19 years of age (see Table).