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Joshua Sharfstein
Harvard Medical School

Paul Wise, MD
Harvard Institute for Reproductive and Child Health Boston, Mass

JAMA. 1996;275(12):908.

	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.

—Dr Margolis and colleagues¹ seek to determine the most cost-effective way to protect a single birth cohort from HBV over the course of their lives. They answer the question: "What is the best strategy to reduce hepatitis B infections 30 years from now?" But they do not fully address the problem: "What is the best strategy to fight hepatitis B infections among all ages today?"

The answer to the latter problem certainly includes both universal infant and adolescent immunization, as Margolis et al suggest in their discussion. But equally important is a third strategy: renewed emphasis on vaccinating older adolescents and adults who have risk factors for imminent HBV infection. Such risk factors include a history of more than two sexual partners in the last 6 months, a recent sexually transmitted disease (STD), or intravenous drug use.²

Aggressive strategies for finding and vaccinating these high-risk . . . [Full Text PDF of this Article]

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