Immunogenicity of two recombinant hepatitis B vaccines in older individuals

Thomas L. Treadwell, Emmet B. Keeffe, John Lake, Alexandra Read, Lawrence S. Friedman, Ira S. Goldman, Charles D. Howell, Maria deMedina, Eugene R. Schiff, Donald M. Jensen, Raymond S. Koff

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


purpose: Currently available hepatitis B vaccines are recombinant, yeast-derived preparations given in 10-μg or 20-μg doses. The optimum dose remains controversial. We sought to assess the relative immunogenicity of two hepatitis B vaccines, given in different doses, in older individuals. patients and methods: In a multicenter, double-blind, randomized clinical trial, a total of 460 healthy subjects between 39 and 70 years of age were screened and immunized with either Engerix-B 20 μg or Recombivax HB 10 μg in standard, intramuscular, 3-dose regimens. Of these, 397 subjects were eligible to continue vaccination. Immunogenicity was measured by determination of antibody to hepatitis B surface antigen (anti-HBs). Seroconversion and seroprotection rates, and geometric mean titers of anti-HBs were calculated at 1, 3, 6, and 8 months after the initial dose of vaccine. results: Seroprotection rates for subjects receiving the 20-μg dose of vaccine were slightly, but not significantly, greater than for subjects receiving the 10-μg dose, at each time point. However, at 3 months, males receiving the higher dose had significantly higher seroprotection rates than males receiving the lower dose: 63% versus 37% (p <0.001). At 8 months, geometric mean titers for the group receiving Engerix-B 20 μg were significantly greater than that for the group receiving Recombivax HB 10 μg: 840 mIU/mL versus 340 mIU/mL (p = 0.001). conclusions: Immunization with the 20-μg dose of recombinant hepatitis B virus vaccine appeared to result in more rapid development of seroprotective anti-HBs titers in older men and in higher titers of anti-HBs at the completion of vaccination when compared to the 10-μg dose. The latter data suggest that the 20-μg dose may result in a longer duration of seroprotective anti-HBs titers.

Original languageEnglish (US)
Pages (from-to)584-588
Number of pages5
JournalThe American Journal of Medicine
Issue number6
StatePublished - Dec 1993


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