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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

    

Hepatitis B Vaccine Brand Changed

http://www.vh.org/adult/provider/pharmacyservices/RXUpdate/2002/01RXU.html

Rx Update: January 2002

Mary Ross, R.Ph., M.B.A., Barbara Mutnick, R.Ph., M.H.P., Joan Murhammer, R.Ph.
Peer Review Status: Internally Reviewed


Beginning January 2, 2002, UIHC will change brands of hepatitis B vaccine (recombinant). The current brand, Recombivax HB® (Merck), will be replaced with Engerix-B® (GlaxoSmithKline).

The CDC considers both Engerix-B® and Recombivax HB® to be safe and effective in the prevention of hepatitis B infections.1 The immune response using one or two doses of a vaccine, followed by one or more subsequent doses from a different manufacturer, has been demonstrated to be comparable to a full vaccination series with a single product.2 The products may be used interchangeably despite the mcg per dose differences; thus, patients who have started their immunization series with Recombivax HB® can finish the series with the appropriate dose of Engerix-B®.

    

The chart below provides the recommended dose* for both Engerix-B® and Recombivax HB®.

Patient Group

Recombivax HB®3

Engerix-B®4

Children (aged 0-19 years)**

5 mcg/0.5 ml

10 mcg/0.5 ml

Adults (Aged 20 or more years)

10 mcg/1 ml

20 mcg/1 ml

Dialysis patients and other immunocompromised persons

40 mcg/1 ml

40 mcg/2 ml***

* 3-dose series given at 0, 1, and 6 months.

* * In children 11 to 15 years of age, a 2-dose series using the adult formulation (20 mcg/1 ml for Engerix-B®) can be given at 0 and 4 to 6 months as an alternative to the 3-dose series.

* * * 4-dose series given at 0, 1, 2, and 6 months (two 20 mcg/ml doses).

The recommended schedule for hepatitis B vaccine is a three-dose series given at 0, 1, and 6 months. The American Academy of Pediatrics and the Advisory Committee on Immunization Practices recommend that hepatitis B vaccination (thimerosal-free product) should be initiated at birth for all infants.2 It can also be given in an accelerated schedule at 0, 1, 2, and 12 months for patients requiring more rapid induction of immunity or for post-exposure prophylaxis. However, there is no clear-cut evidence that proves this four-dose regimen provides greater protection than the standard three-dose series.5

    

References:

1.    MMWR 1991;40(RR-13):1-24.

2.    Committee on Infectious Disease 2000 Red Book: Report of the Committee on Infectious diseases. Elk Grove Village, IL;American Academy of Pediatrics.

3.    Merck & Co. Recombivax HB package insert. Philadelphia, PA: 2000 February.

4.    SmithKline Beecham. Engerix-B package insert. Philadelphia, PA:2000 December.

5.    ACP Task Force on Adult Immunization and Infectious Disease Society of America. Guide for Adult Immunization. Philadelphia, PA; American College of Physicians: 1994.