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Guy Lonergan, MD, MSc
Montreal General Hospital Montreal, Quebec

JAMA. 1995;273(13):999.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The review of hepatitis A prevention in travelers by Dr Steffen and colleagues¹ mentions the recently introduced vaccine based on the strain HM 175 (Havrix, SmithKline Beecham Biologicals, Rixensart, Belgium), usually administered at a dose of 720 enzyme-linked immunosorbent assay (ELISA) units. A dose of 1440 ELISA units is also mentioned.

It has not been shown that a dose of 1440 units provides more protection than a dose of 720 units; published studies examining protective efficacy used 360 or 720 units. At best, the added benefit will be small. More importantly, the safety of a 1440-unit vaccine has not been adequately studied. Its use has been described in three publications.

In a study by Just and Berger,² 60 subjects received the 1440-unit vaccine and no serious adverse effects were reported. The extent of monitoring was self-reporting and liver enzyme testing. In a study by Jilg . . . [Full Text PDF of this Article]

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