Hepatitis B Booster Dose Time

Recommended Doses Of Hepatitis B Vaccine

Recommended doses of hepatitis B by vaccine type, age, formulation, dosage and schedule.

Download PDF version formatted for print: Recommended Doses of Hepatitis B Vaccine

* The schedule for hepatitis B is flexible, but minimal intervals and minimum ages need to be observed:

• There should be at least 4 weeks between doses 1 and 2, and at least 8 weeks between doses 2 and 3.
• The minimum interval for the overall series from dose 1 to final dose is 4 months .
• Infants, should receive the final dose of hepatitis B vaccine on or after 6 months of age, otherwise long term immunity may be impacted.

Note:

• Adults who are immunocompromised or on dialysis require a larger dose of hepatitis B vaccine.
• The Engerix-B dose required is 40mcg/2.0mL on a scheduled of 0, 1, 2, and 6 months.
• For Recombivax HB, a special formulation is available. The dose is 40mcg/1.0mL given on a schedule of 0, 1, and 6 months

Combination Vaccines:

Us Infant Hepatitis B Vaccine Schedules

*Please note that the first dose should be given as soon as possible. Additional doses require minimum time intervals between doses in order for the vaccine to be effective.

3-Dose Vaccine Series for Infants

Since 1991, ALL medically stable infants with a birth weight of at least 2,000 g in the U.S. are recommended to receive the first dose of hepatitis B vaccine within 24 hours of birth. The additional 2 doses are given at 1 month and 6 months of age.

4-Dose Vaccine Combination Series for Infants

Combination vaccines, such as the pentavalent and hexavalent vaccines, include protection against 5 or 6 diseases, including hepatitis B. The first shot is usually given at 6 weeks of age, but in order to protect infants from hepatitis B beginning at birth, a monovalent or single dose of the hepatitis B vaccine is also recommended within 24 hours of birth. The hepatitis B vaccine series can then be completed with the pentavalent or hexavalent vaccine with the recommended schedule.

Infants Born To Mothers Who Have Hepatitis B: Hepatitis B Vaccine Schedules

*Please note that the first dose should be given as soon as possible. Additional doses require minimum time intervals between doses in order for the vaccine to be effective.

Protecting Your Baby

Infants born to women with hepatitis B must receive accurate doses of hepatitis B vaccine and hepatitis B immune globulin to ensure complete protection. In order to protect these infants, medications should be given immediately after birth in the delivery room or within the first 12-24 hours of life*.

* See Testing and Treatment During Pregnancy section for details. Please note that testing of all pregnant women for hepatitis B is a global recommendation.

3-Dose Vaccine Series for Infants

The World Health Organization recommends that infants born to hepatitis B positive mothers receive the first dose of the hepatitis B vaccine within 24 hours of birth, and ideally a dose of hepatitis B immunoglobulin . These shots must be followed by the additional vaccine doses given on the recommended schedule. In the U.S., infants should follow a 1 month and 6-month schedule for the additional two doses.

4-Dose Combination Vaccine Series for Infants

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Hepatitis B Vaccine On The Nhs

A hepatitis B-containing vaccine is provided for all babies born in the UK on or after 1 August 2017. This is given as part of the 6-in-1 vaccine.

Hospitals, GP surgeries and sexual health or GUM clinics usually provide the hepatitis B vaccination free of charge for anyone at risk of infection.

GPs are not obliged to provide the hepatitis B vaccine on the NHS if you’re not thought to be at risk.

GPs may charge for the hepatitis B vaccine if you want it as a travel vaccine, or they may refer you to a travel clinic for a private vaccination. The current cost of the vaccine is around £50 a dose.

Why Is The Hepb Vaccine Recommended

People who dont know they’re infected can spread the hepatitis B virus. So it cant be avoided just by being careful. That’s why health experts recommend that all babies get the vaccine right from birth.

The HepB injection usually creates long-term immunity. Most infants who get the HepB series are protected from hepatitis B infection beyond childhood, into their adult years.

Eliminating the risk of infection also decreases risk for cirrhosis of the liver, chronic liver disease, and liver cancer.

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The Hepatitis B Vaccine Is Recommended For:

• People who live with someone who has hepatitis B
• People with chronic liver disease or end-stage kidney disease
• Adults ages 1959
• Adults, 60 and older, with or without known risk factors for hepatitis B infection

People who have not completed the vaccine series should contact their primary care provider to discuss the vaccine.

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Guidance On Reporting Adverse Events Following Immunization

Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.

Refer to Reporting Adverse Events Following Immunization in Canada and Adverse events following immunization in Part 2 for additional information about AEFI reporting.

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What To Do If You Miss A Scheduled Dose

The recommended schedule for the HBV vaccine follows a three-dose pattern, with all doses complete within 6 months. The good news is that if you miss a dose, you dont need to start the series of shots all over.

If you missed getting the second dose 1 month after the first, make an appointment as soon as possible. If you miss the third dose, you should also try to get it as quickly as possible. Keep in mind that the second and third doses

Screen For Contraindications And Precautions

• Do not administer Heplisav-B to individuals with a history of severe allergic reaction after a previous dose of any hepatitis B vaccine or to any component of Heplisav-B, including yeast.
• Consult the package insert for precautions, warnings, and contraindications and Hepatitis B Vaccine Safety for additional information and possible side effects.

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Hepatitis B Vaccination In Pregnancy

Hepatitis B infection in pregnant women may result in severe disease for the mother and chronic infection for the baby.

This is why the hepatitis B vaccine is recommended for pregnant women who are in a high-risk category.

There’s no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.

And, as it’s an inactivated vaccine, the risk to the unborn baby is likely to be negligible .

Which Adults Should Be Vaccinated Against Hepatitis B

According to CDC recommendations, adults in the following groups are recommended to receive hepatitis B vaccine:

General

• All people age 18 years and younger.
• Anyone 19 years and older who wants to be protected from hepatitis B.

People at risk for infection by sexual exposure

• Sex partners of people who are hepatitis B surface antigen -positive.
• Sexually active people who are not in long-term, mutually monogamous relationships.
• People seeking evaluation or treatment for a sexually transmitted disease.
• Men who have sex with men.

People at risk for infection by percutaneous or permucosal exposure to blood or body fluids

• Current or recent illegal injection drug users.
• Household contacts of people who are HBsAg-positive.
• Residents and staff of facilities for developmentally challenged people.
• Healthcare and public safety workers with reasonably anticipated risk for exposure to blood or blood-contaminated body fluids.
• People with end-stage renal disease, including predialysis, hemo-, peritoneal- and home-dialysis patients.

Others

• International travelers to regions with intermediate or high levels of endemic HBV infection.
• People with chronic liver disease.
• People with HIV infection.
• People with diabetes who are age 19 through 59 years. For those age 60 and older, clinicians should make a determination of need for
• vaccination based on their patients’ situation.

In a future issue, we will review the various hepatitis B serologic tests, who needs testing, and when they need it .

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How Is The Hepatitis B Vaccine Made

People are protected against hepatitis B virus infection by making an immune response to a protein that sits on the surface of the virus. When hepatitis B virus grows in the liver, an excess amount of this surface protein is made. The hepatitis B vaccine is made by taking the part of the virus that makes surface protein and putting it into yeast cells. The yeast cells then produce many copies of the protein that are subsequently used to make the vaccine. When the surface protein is given to children in the vaccine, their immune systems make an immune response that provides protection against infection with the hepatitis B virus.

The first hepatitis B vaccine was made in the 1980s by taking blood from people infected with hepatitis B virus and separating or purifying the surface protein from the infectious virus. Because blood was used, there was a risk of contaminating the vaccine with other viruses that might be found in blood, such as HIV. Although contamination with HIV was a theoretical risk of the early, blood-derived hepatitis B vaccine, no one ever got HIV from the hepatitis B vaccine. That is because the blood used to make vaccine was submitted to a series of chemical treatments that inactivated any possible contaminating viruses. Today, there is no risk of contaminating the vaccine with other viruses because the surface protein is manufactured in the laboratory.

Recommended Adult Dosing Volume Of Monovalent Hepatitis B Vaccine

• Age 19 years and younger: Use 0.5 mL per dose .
• Age 20 years and older: 1.0 mL per dose .

For a one-page sheet reviewing the hepatitis B dosing schedule for children and adults, consult IACs Hepatitis A and B Vaccines: Be Sure Your Patients Get the Correct Dose. For complete dosing information, consult the ACIP hepatitis B vaccine recommendations for adults.

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Do The Benefits Of The Hepatitis B Vaccine Outweigh Its Risks

Every year in the United States about 2,000 people die following an overwhelming hepatitis B virus infection. In addition, every year about 22,000 people are infected with hepatitis B. Some of them will remain chronically infected, putting them at high risk of the long-term consequences of hepatitis B virus infection: cirrhosis and liver cancer. In fact, with the exception of influenza and COVID-19 viruses, hepatitis B virus causes more severe disease and death in the United States than any other vaccine-preventable disease. On the other hand, the hepatitis B vaccine is an extremely rare cause of a severe allergic reaction called anaphylaxis. To date, no one has died from this reaction, but it is theoretically possible that this could occur.

Because hepatitis B virus is a common cause of severe disease and death in the United States, and because the hepatitis B vaccine does not cause permanent damage or death, the benefits of the hepatitis B vaccine clearly outweigh its risks.

A Look At Each Vaccine: Hepatitis B Vaccine

View larger image The hepatitis B vaccine is given to prevent the severe liver disease that can develop when children or adults are infected with hepatitis B virus. The hepatitis B vaccine is given as a series of three shots. The first dose is given within 24 hours of birth. The second dose is given one to two months after the first dose, and the third dose is given between 6 months and 18 months of age. The vaccine is also recommended for those up to 60 years of age who have not previously received it and those 60 years and older who are at increased risk or who simply want the protection afforded by vaccination.

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Indications For Hepatitis B Vaccine

HepB vaccine is a routine childhood vaccination .

HepB vaccine also is indicated for all adults aged 19 through 59 years who have not been previously vaccinated.

HepB vaccine also is indicated for adults aged 60 years and older who have not been previously vaccinated and who have any of the following:

• A desire for protection from hepatitis B

• A sexually active lifestyle in people who are not in a long-term, mutually monogamous relationship

• Need for evaluation or treatment of a sexually transmitted infection

• Current or recent use of illicit injection drugs

• Sex between men

• Employment in which workers may be exposed to blood or other potentially infectious body fluids

• Diabetes in people < 60 years and sometimes in those 60 years

• End-stage renal disease

• A chronic liver disorder

• Household contact and/or sexual contact with people who are positive for hepatitis B surface antigen

• Travel to endemic areas

• Time spent in correctional facilities or in facilities that provide sexually transmitted infection treatment, HIV testing and treatment, drug abuse treatment and prevention services, services to injection-drug users or men who have sex with men, or care for patients with developmental disabilities or with end-stage renal disease

The combination HepA and HepB vaccine can be used in people 18 years who have indications for either hepatitis A or hepatitis B vaccine and who have not been previously vaccinated with one of the vaccine components.

Many People With Hbv Dont Know They Have It

HBV infections are becoming less common in the United States. But HBV is still widespread in other parts of the world. Around 257 million people living around the world currently have HBV, and many of them dont know it. Chronic HBV is often asymptomatic, and even when it isnt, it can take months for symptoms to show up.

HBV can be transmitted through sexual contact and the use of IV drugs , and other risk factors. Although rare, there

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What Is Hepatitis B Virus

Hepatitis B virus attacks the liver. Hepatitis B virus infections are known as the silent epidemic because many infected people dont experience symptoms until decades later when they develop hepatitis , cirrhosis , or cancer of the liver . Every year in the United States about 22,000 new hepatitis B infections occur and about 2,000 people die from their infections.

Immunisation Against Hepatitis B For Children

Vaccination is the best protection against hepatitis B infection and is recommended for all infants and young children, adolescents and those in high-risk groups. Vaccination can be with a vaccine against hepatitis B alone or with a combination vaccine.

Protection against hepatitis B is available free of charge under the National Immunisation Program Schedule.

In Victoria, vaccination against hepatitis B is free for all babies and children including:

• Babies at birth vaccinate with hepatitis B vaccine as soon as possible after birth.
• Babies at 2, 4 and 6 months immunisation in the form of a diphtheria, tetanus, whooping cough, hepatitis B, polio and Haemophilus influenzae type b vaccine .
• Premature babies at 12 months premature babies born under 32 weeks gestation or under 2,000g birth weight receive a single booster dose.
• Children up to and including 20 years of age.

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Persons With Inadequate Immunization Records

Evidence of long term protection against HB has only been demonstrated in individuals who have been vaccinated according to a recommended immunization schedule. Independent of their anti-HBs titres, children and adults lacking adequate documentation of immunization should be considered susceptible and started on an immunization schedule appropriate for their age and risk factors. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information.

What Is In The Hepatitis B Vaccine

Vaccines are given by a course of three injections, usually as part of the 6-in-1 vaccine scheme.

Although there are different types of vaccines, they usually contain one of the proteins from the surface of the hepatitis B virus thats then inserted in to the genetic code into yeast cells which stops the risk of viral DNA getting into the final product.

They also contain small amounts of sodium chloride and aluminium, and can contain yeast and formaldehyde.

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When To Delay Or Avoid Hepb Immunization

Doctors delay giving the vaccine to babies who weigh less than 4 pounds, 7 ounces at birth whose mothers do not have the virus in their blood. The baby will get the first dose at 1 month of age or when the baby is discharged from the hospital.

The vaccine is not recommended if your child:

• is currently sick, although simple colds or other minor illnesses should not prevent immunization
• had a serious allergic reaction after an earlier dose of the vaccine or is allergic to baker’s yeast