[Hepatitis B vaccination - before a breakthrough?].

Within the next few months hepatitis B vaccine will be introduced in Switzerland, a country where hepatitis B is one of the most frequent infectious disorders. The vaccines so far developed are produced from blood of healthy HBsAg carriers. HBsAg is then purified and possible infectious material is inactivated by formalin or heat. Two vaccines will soon be available, one produced by Merck Sharp & Dohme, which is given at day 0 and after 1 and 6 months in doses of 20 microgram or 40 microgram, and the other from the Pasteur Institute, which is given at day 0 and after 1 and 2 months in doses of 5 microgram. Preliminary trials have shown that the vaccines are safe and that 95-98% of healthy individuals develop anti-HBs. Protection of HBV infection is better than 90%. Immunosuppressed individuals, such as hemodialysis patients, developed anti-HBs in a retarded fashion and less frequently, but such patients also appear to be protected. Results of large scale trials will soon available. Mass vaccination is not intended, but vaccination will be recommended for high risk groups such as medical personnel, certain high risk patient groups, contacts of HBsAg carriers, drug addicts, homosexuals, and certain groups of travellers to high risk countries.