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April 5, 1995

Hepatitis A Vaccine: Which Dose Is Best?-Reply

Author Affiliations

University of Zurich Zurich, Switzerland

JAMA. 1995;273(13):999-1000. doi:10.1001/jama.1995.03520370039030

In Reply.  —Dr Lonergan is right—Havrix administered at a dose of 1440 ELISA units does not offer significantly more protection than a dose of 720 ELISA units. The seroconversion rate after the primary course of two doses of the 720-unit Havrix vaccine already exceeds 95%. The advantages of the 1440-unit hepatitis A vaccine, in contrast, are that travelers need only one injection instead of two of 720 units prior to departure, and a high seroconversion rate is achieved more rapidly (ie, within 2 weeks instead of 4 weeks).The 1440-unit vaccine is marketed in several countries, including the United Kingdom and Switzerland, and the safety of this dosage has been extensively studied. In addition to the initial small studies cited by Lonergan, Victor et al,1 Briem and Safary,2 and van Damme et al3 have recently published their results. Additional German and Swiss studies have been presented at

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