Impaired Immunogenicity of Hepatitis B Vaccine in Obese Persons

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Abstract
To the Editor: The plasma-derived hepatitis B vaccine (Heptavax B, Merck Sharp & Dohme) is currently recommended for medical personnel at high risk of acquiring hepatitis B.1 This recommendation is based in part on field trials that showed the vaccine to be safe and capable of eliciting an antibody response in more than 85 percent of recipients.2 3 4 However, antibody-response rates as low as 50 to 70 percent have recently been reported in some community hospitals,5 6 7 8 with poor response rates variably linked with advanced age,6 female sex6 , 7 or injections into the buttocks rather than the deltoid.8 We previously described factors associated . . .