The shame of American medicine

This was sent to me from another board by a friend:

Question
Until recently, children under 11 who were not exposed to hepatitis B were
given 2.5 mcg of vaccine (Recombivax). Subsequently, a recommendation was
made to give a higher dose (the dose previously reserved for infants born to
Hep B antigen-positive mothers). What is the evidence that this higher dose
for children not at immediate risk is necessary?
Dr. Peter Klainbard


Response
from Russell Steele, MD, 12/4/01
The reason for the change in concentration of Recombivax (Merck; Whitehouse
Station, New Jersey) was not that the higher concentration was more
efficacious, but simply that having 2 products was confusing to clinicians
and resulted in the wrong products being administered to children at high
risk. The pharmaceutical company decided to make a single product that
contained 5 mcg of vaccine per dose for all individuals. The cost was kept
the same and physicians were happier that mistakes would be minimized.

Suggested Reading
Wu JS, Hwang LY, Goodman KJ, et al. Hepatitis B vaccination in high-risk
infants: 10 year follow-up. J Infect Dis. 1999;179:1319-1325.