In this dose-response study evaluating 3 different doses and 2 time sc
hedules, the highest dose, 25 units of viral protein antigen, induced
a seroconversion antibody response against hepatitis A virus (anti-HAV
) over 10 mIU in all vaccinees by week 3 after one dose, indicating ra
pid onset of protective antibody levels. Following the second dose, gi
ven 4 weeks later, rising titers were observed for 20 weeks, when the
third and final dose of 25 units was given. The GMT of anti-HAV at 24
weeks (before the third vaccine injection) was 398 mIU/ml for the 25-u
nit dose, compared to 42 and 65 mIU/mi, respectively, for the 12.5 uni
t and 6.25 unit doses. The third vaccine dose at 24 weeks gave a boost
er response in all vaccinees, but the increase in titers was most pron
ounced in the 25 unit group, which had reached a GMT of 6593 mIU/ml wh
en tested 4 weeks later. Side-effects included mainly local reactions
and a few cases of mild diarrhoea, and did not differ for the 3 doses
studied. In Scandinavia, hepatitis A vaccines will probably be used ma
inly for vaccination of foreign travellers. This category usually requ
ires a rapid immunization schedule with few doses. Two doses approxima
tely 3-4 weeks apart will probably be accepted by most travellers, and
a single dose may provide short-term protection for most individuals.
The need and timing for a booster dose will have to be further studie
d.