Abstract
To the Editor.— We recently reported a multivariate analysis of the risk factors associated with a poor immunogenic response to the hepatitis B plasma vaccine among 194 employees of a community hospital. 1 The vaccine had been stored and administered according to manufacturer's recommendations. Employees received all three doses of the vaccine in the buttock with a 2.5-cm, 23-gauge needle. Overall, only 56% (108/194) of the employees developed antibody to hepatitis B surface antigen (anti-HBs) as measured by the enzyme-linked immunosorbent assay (Abbott). A high body weight-height index (a measure of obesity) was found to be predictive of a lack of antibody response. To date, 41 of the 86 employees who initially failed to develop anti-HBs have received two additional doses of the vaccine in the deltoid using a 2.5-cm, 23-gauge needle. The initial repeated immunization was conducted 425 ± 15 days after the completion of the primary series, and
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