To the Editor.
—Drs Margolis and Presson1 have provided a well-reasoned Editorial on host factors relevant to the suboptimal response to recombinant hepatitis B vaccines (HBVs) observed among adults and reported in that issue of JAMA.2,3 They point out that observed differences in response to the two commercially available recombinant HBVs (Engerix-B, SmithKline Beecham Pharmaceuticals, Philadelphia, Pa, and Recombivax HB, Merck Sharp & Dohme, West Point, Pa) identified in one of the studies3 must be viewed cautiously since the design of that study was retrospective. They also indicate that prospective studies are needed to answer the question of whether or not true differences in the immunogenicity of the two vaccines exist.A prospective, double-blind, randomized controlled trial comparing the two vaccines (20 μg of Engerix-B and 10 μg of Recombivax HB) in adults between 39 and 70 years of age (mean age, 49 years) has now been
Koff RS. Immunogenicity of Hepatitis B Vaccines. JAMA. 1994;272(3):201. doi:10.1001/jama.1994.03520030041018