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A small proportion of hepatitis B vaccinees do not respond to the standard three-dose regimen. To immunize them, various salvage protocols — using alterations in vaccine dose, site of inoculation, or schedule — have been tried with variable degrees of success. Swedish researchers now propose using high-dose combined hepatitis A/B vaccine as another protocol for nonresponders.
Three double doses of the combined vaccine were given to 44 healthy adults who had not had therapeutic responses to at least four doses of hepatitis B vaccine. All were seronegative to hepatitis A; 26 (59%) and 42 (95%) developed protective hepatitis B antibodies after the first and last vaccine doses, respectively. All seroconverted to hepatitis A positivity as well, a…