Hepatitis B Adult Vaccine Dosing Information
Usual Adult Dose for Hepatitis B Prophylaxis:
Primary Vaccination:Engerix-B:19 years and younger: Three doses intramuscularly on a 0, 1, and 6 month schedule20 years and older: Three doses intramuscularly on a 0, 1, and 6 month scheduleHeplisav-B: Two doses intramuscularly one month apartRecombivax-HB: 19 years and younger: Three doses intramuscularly on a 0, 1, and 6 month schedule 20 years and older: Three doses intramuscularly on a 0, 1, and 6 month schedule Known or Presumed Hepatitis B Exposure:Engerix-B : Use recommended doses of on a 0, 1, and 6 month schedule OR a 0, 1, 2, and 12 month schedule.Recombivax-HB: Refer to recommendations of the Advisory Committee on Immunization Practices
This Vaccine Side Effects
Get emergency medical help if you have signs of an allergic reaction or a severe skin reaction .
You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.
Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.
Hepatitis B adult vaccine may cause serious side effects. Call your doctor at once if you have:
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a light-headed feeling, like you might pass out
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seizure-like muscle movements or
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redness, pain, swelling, or a lump where the shot was given.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.
Who Should Get The Hbv Vaccine
The Centers for Disease Control and Prevention recommends that all children and adults up to age 59 should receive the hepatitis B vaccine.
Infants should get their first hepatitis B vaccine within 24 hours of birth and complete their doses by age 6 to 18 months.
All unvaccinated children and adults through age 59 should receive the vaccine. Also, unvaccinated adults over the age 60 who are at risk of hepatitis B should get the vaccine.
Adults over age 60 who are not at risk of hepatitis B may also choose to get the shot.
Several types of the HBV vaccine are also safe to administer to pregnant women.
- people who have had more than one sex partner in the last 6 months
- men who have sex with men
- people seeking treatment for a sexually transmitted infection
- people whose partners or household members have hepatitis B
- people who inject drugs
- people who live or work in care facilities
- people who are on dialysis
- travelers to countries where hepatitis B is common
- people with chronic liver disease, HIV, or hepatitis C
- people who are in jail or prison
People who have diabetes should talk with a healthcare professional about their risk for contracting hepatitis B.
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Indications For Hepatitis B Vaccine
HepB vaccine is a routine childhood vaccination .
HepB vaccine also is indicated for adults who have not been previously vaccinated when any of the following is present:
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A desire for protection from hepatitis B in people who have not been previously vaccinated
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A sexually active lifestyle in people who are not in a long-term, mutually monogamous relationship
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Need for evaluation or treatment of a sexually transmitted infection
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Current or recent use of illicit injection drugs
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Sex between men
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Employment in which workers may be exposed to blood or other potentially infectious body fluids
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Diabetes in people < 60 years and sometimes in those 60 years
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End-stage renal disease
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A chronic liver disorder
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Household contact and/or sexual contact with people who are positive for hepatitis B surface antigen
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Travel to endemic areas
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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
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Pregnant women if at risk of infection or severe outcome resulting from infection during pregnancy
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.
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 .
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Us Children And Adult 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 Children and Adults
The hepatitis B vaccine is an injection that is generally given in the arm as a three-dose series on a 0, 1, and 6-month schedule. Alternative schedules may be considered, noting that a third dose at 6 months, meeting minimum intervals between doses, is needed for maximum, long-term protection. Completing the hepatitis B vaccine series, preferably beginning at birth, will ensure protection against hepatitis B, hepatitis delta and lower the lifetime risk of liver cancer. Greater than 90% of babies and up to 50% of young children who are not vaccinated and are infected with hepatitis B will have lifelong infection, which makes the birth dose essential to their protection.
There are four, 3-dose vaccine brands approved in the U.S.
- PreHevbrio PreHevbrio is only approved for adults age 18 and over.
2-Dose Vaccine Series
Who Should Not Receive The Hepatitis B Vaccine
Talk to your healthcare provider before getting the hepatitis B vaccine if:
- You have had a severe allergic reaction to the hepatitis B vaccine or any of its ingredients in the past.
- You have had an allergic reaction to yeast in the past.
- You are moderately or severely ill.
- You are currently taking immunosuppressive medications.
In addition, pregnant people should not receive the Heplisav-B or PreHevbrio vaccines until more safety information is available.
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How Do Inactivated Viral Vaccines Work
Inactivated viralvaccines are sterile biologic products that provide immunity against viral infections. Inactivated viral vaccines work by stimulating the bodys immune system to produce antibodies against specific types of viruses, and protect a person from becoming infected when exposed to these viruses.
In the case of SARS-CoV-2 coronavirus that causes respiratory illness and has led to the COVID-19 pandemic, vaccines do not entirely prevent infection but protect vaccinated individuals from serious illness and hospitalization from the disease.
Inactivated viral vaccines contain particles of proteins or genetic material from viruses. Inactivated viral vaccines may also contain substances that preserve and stabilize the vaccine, and enhance immune response. Some viral vaccines are delivered in inactivated harmless viruses such as human adenovirus.
Inactivated viral vaccines may be made from:
- Surface proteins of the viruses enable the virus to hold on to a human cell, enter inside and replicate.
- Modified RNA particles from the virus can enter host cells and induce the production of viral antigen, which stimulates an immune response from the body.
- Recombined DNA material from multiple strains and subtypes of viruses, killed to eliminate disease-causing capability.
Currently, inactivated viral vaccines approved by the FDA protect against viral infectious diseases that include:
- Coronavirus disease , caused by SARS-Cov-2 virus
Adults
Other Reported Adverse Events And Conditions
While serious events and chronic illnesses such as chronic fatigue syndrome, multiple sclerosis, Guillain-Barré syndrome, rheumatoid arthritis and sudden infant death syndrome have been alleged or reported following HB vaccination, no evidence of a causal association has been demonstrated in a number of studies.
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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
Selected Safety Information For Recombivax Hb Selected Safety Information For Recombivax Hb
Do not administer RECOMBIVAX HB® to individuals with a history of severe allergic or hypersensitivity reactions after a previous dose of any hepatitis B-containing vaccine or to any component of RECOMBIVAX HB, including yeast.
The vial stopper and the syringe plunger stopper and tip cap contain dry natural latex rubber, which may cause allergic reactions in latex-sensitive individuals.
Apnea following intramuscular vaccination has been observed in some infants born prematurely. Decisions about when to administer an intramuscular vaccine, including RECOMBIVAX HB, to infants born prematurely should be based on consideration of the individual infants medical status and the potential benefits and possible risks of vaccination. For RECOMBIVAX HB, this assessment should include consideration of the mothers hepatitis B antigen status and high probability of maternal transmission of hepatitis B virus to infants born to mothers who are HBsAg positive if vaccination is delayed.
Hepatitis B vaccination should be delayed until 1 month of age or hospital discharge in infants weighing < 2000 g if the mother is documented to be HBsAg negative at the time of the infants birth. Infants weighing < 2000 g born to HBsAg positive or HBsAg unknown mothers should receive vaccine and hepatitis B immune globulin in accordance with ACIP recommendations if HBsAg status cannot be determined.
Vaccination with RECOMBIVAX HB may not protect all individuals.
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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.
How Common Is Hepatitis B
One U.S. study following trends in hepatitis B infection over a three-year periodfound that 4.3% of the population had a past or present HBV infection.
Estimates suggest that about 240 million people around the world have chronic hepatitis B. Up to 1.89 million people in the United States have a chronic HBV infection.
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How Is This Vaccine Given
This vaccine is given as an injection into a muscle. A healthcare provider will give you this injection.
The hepatitis B vaccine is given in a series of 2 to 4 shots. The booster shots are sometimes given 1 month and 6 months after the first shot. If you have a high risk of hepatitis B infection, you may be given an additional booster 1 to 2 months after the third shot.
Your individual booster schedule may be different from these guidelines. Follow your doctor’s instructions or the schedule recommended by the health department of the state you live in.
Accelerated Us Children And Adult 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.
In some instances, it may be necessary to vaccinate within a short period of time to ensure protection before travel. There are accelerated schedules to provide the highest level of protection over a short period of time. Individuals who need an accelerated schedule must have a booster dose at 1 year to ensure long-term protection. Note that the 2-dose Heplisav-B vaccine will also ensure maximum protection over a 1-month period without the need for a booster dose at 1 year.
4-Dose Vaccine Series for Children and Adults
Engerix-B is a 3-dose vaccine that can be given on an accelerated, four-dose schedule, with 3 shots administered within 2 months, and a booster dose at 1 year to provide maximum long-term protection.
4-Dose Combination Hepatitis A and B Vaccine Series
Twinrix is a 4-dose vaccine that can be given on an accelerated schedule to provide protection against hepatitis A and B. Three doses are administered within 1 month, followed by a booster shot at 1 year. This is a common choice of vaccine for those travelling on short-notice outside the U.S. It is important to complete the booster dose at 1 year, to ensure long-term protection.
2-Dose Vaccine Series
Additional Resource Links:
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Concurrent Administration Of Vaccines
HB-containing vaccines may be administered concomitantly with other vaccines or with HBIg. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections.
Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
What Hepatitis B Immunisation Involves
Full protection involves having 3 injections of the hepatitis B vaccine at the recommended intervals.
Babies born to mothers with hepatitis B infection will be given 6 doses of hepatitis B-containing vaccine to ensure long-lasting protection.
If you’re a healthcare worker or you have kidney failure, you’ll have a follow-up appointment to see if you have responded to the vaccine.
If you have been vaccinated by your employer’s occupational health service, you can request a blood test to see if you have responded to the vaccine.
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What Other Drugs Interact With Hepatitis B Vaccine
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.
- Severe Interactions of Hepatitis B Vaccine include:
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.
Usual Pediatric Dose For Exposure To Hepatitis B Virus
Nabi-HB, prophylaxis of infants born to HBsAg positive mothers:
- Mother not screened for HBsAg: If mother found positive after screening, 0.5 mL intramuscularly as soon as possible, no later than 1 week after birth repeat dose at 1 to 2 months and again at 6 months.
- Unvaccinated: 0.06 mL/kg intramuscularly immediately administer concurrently with hepatitis B vaccine.
- Unvaccinated: Initiate hepatitis B vaccine series if test for anti-HBs is inadequate, 0.06 mL/kg intramuscularly.
- Unvaccinated: Initiate hepatitis B vaccine series
- Unvaccinated: Initiate hepatitis B vaccine series
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For Adults And Children
This vaccine schedule involves three doses within 2 months, followed by a booster dose at 1 year.
The initial accelerated doses provide immediate protection from HBV, and the booster dose helps provide long-term protection.
Below is the accelerated vaccination schedule approved for both adults and children:
| Vaccine series | |
|---|---|
| 2 months after the first dose | 1 year after the first dose |
What Is Hepatitis B Vaccine
Hepatitis B is a serious disease caused by a virus. Hepatitis causes inflammation of the liver, vomiting, and jaundice . Hepatitis can lead to liver cancer, cirrhosis, or death.
The hepatitis B adult vaccine is used to help prevent this disease in adults. The dialysis form of this vaccine is for adults receiving dialysis.
This vaccine helps your body develop immunity to hepatitis B, but it will not treat an active infection you already have.
Vaccination with hepatitis B adult vaccine is recommended for all adults who are at risk of getting hepatitis B. Risk factors include: living with someone infected with hepatitis B virus having sexual contact with infected people having hepatitis C, chronicliver disease, kidney disease, diabetes, HIV or AIDS being on dialysis using intravenous drugs living or working in a facility for developmentally disabled people working in healthcare or public safety and being exposed to blood or body fluids living or working in a correctional facility being a victim of sexual abuse or assault and traveling to areas where hepatitis B is common.
Like any vaccine, the hepatitis B vaccine may not provide protection from disease in every person.
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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.