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.
|
