Hepatitis Vaccine For Adults Schedule

Important Information About Vaccine And Hepatitis B Immunoglobulin Shot Administration

Where available, the hepatitis B birth-dose and HBIG should be administered within 24 hours of birth in order to prevent the transmission of hepatitis B from mother to child. It is very important that the shots be given in opposite limbs, to ensure the highest effectiveness. Please see chart above for more information.

Hepatitis B Vaccination Schedule For Children And Infants

The Centers for Disease Control and Prevention recommends that babies and children receive three 0.5 milliliter doses of either Engerix-B or Recombivax HB, starting just after birth.

The current recommended hepatitis B vaccine schedule for children and infants is as follows:

If your child is undergoing hemodialysis, your healthcare provider may recommend that they receive additional doses of the HBV vaccine.

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:

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Dosage And Vaccination Schedule

Dosage varies according to age and type of vaccine used: follow manufacturer’s instructions.

Child: one dose = 5 to 10 micrograms

Adult: one dose = 10 to 20 micrograms

• Standard schedule
• Neonate and infant:
• One dose as soon as possible after birth then a 2nd dose at 6 weeks and a 3rd dose at 14 weeks

• One dose as soon as possible after birth then 3 doses administered 4 weeks apart with the 1st at 6 weeks, the 2nd at 10 weeks and the 3rd at 14 weeks

• Child, adolescent, adult: schedule 0-1-6

2 doses 4 weeks apart, then a 3rd dose 6 months after the 1st dose

• Accelerated schedule, when rapid protection is required in the event of post-exposure prophylaxis

3 doses administered during the same month on D0-D7-D21, then a 4th dose one year after the 1st dose

Hepatitis B Vaccine Schedule For Adults

• Frequently Asked Questions

Hepatitis B is a vaccine-preventable viral disease that involves inflammation of the liver.

The hepatitis B virus usually leads to a short-term infection known as acute hepatitis B. If their infection is left untreated, some people develop chronic hepatitis B. Chronic hepatitis B is a serious, permanent condition that can cause organ damage, cirrhosis , liver cancer, liver failure, and even death.

According to the Centers for Disease Control and Prevention , all people should be vaccinated against hepatitis B starting at birth. Adults who are at risk of developing hepatitis B should also receive the vaccine, which is highly effective in preventing infection.

Read on to learn more about the hepatitis B vaccine for adults, including who should receive it, the details of the dosage schedule, side effects, and more.

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Adults Recommended To Receive Hepb Vaccine:

TheAdvisory Committee on Immunization Practices recommends that the following people should receive hepatitis B vaccination:

• All infants
• Unvaccinated children aged < 19 years
• Adults aged 19 through 59 years
• Adults aged 60 years and older with risk factors for hepatitis B

The following groups may receive hepatitis B vaccination:

• Adults aged 60 years and older without known risk factors for hepatitis B

Risk factors for hepatitis B

• Persons at risk for infection by sexual exposure
• Sex partners of persons who test positive for hepatitis B surface antigen
• Sexually active persons who are not in a long-term, mutually monogamous relationship
• Persons seeking evaluation or treatment for a sexually transmitted infection
• Men who have sex with men

Compliance With Accelerated Vs Standard Vaccination Schedules In Different Populations

Table 2Overview of hepatitis B vaccine uptake according to vaccination schedule, in different atrisk populations

*Schedule expressed in months 0 1/4 3/4 therefore corresponds to 0.7.21days type of vaccination schedule: coded as S , SS , A or SA parentheses indicate schedules without the final dose numbers and percentages either reported in the paper, or calculated from the reported values

SW/MSM/Multiple partners/STI clinic attendants

Several studies have reported being able to administer three doses of hepatitis B vaccine to a higher proportion of the population targeted, when an accelerated or a superaccelerated schedule was used, at least the primary part of it. Unfortunately, few of these studies report immunogenicity data this is mainly due to the difficulties to administer three vaccine doses, and thus the low proportion that can actually be tested afterwards.39,40,41,42,43,44,45,46

A recent paper that did report immunogenicity data studied a shortened standard schedule as an alternative option, in a setting where other strategies are used to improve the compliance. Even if the 0.1.4months schedule failed to significantly improve the compliance, it offered equal protection within a shorter interval.47

Drug users

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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

Future Research And Monitoring Priorities

CDC and ACIP will continue to assess safety of PCV15 and PCV20 vaccines, monitor the impact of implementation of new recommendations, and assess postimplementation vaccine effectiveness and update pneumococcal vaccination recommendations as appropriate.

Before administering PCV20, PCV15, or PPSV23, health care providers should consult relevant package inserts regarding precautions and contraindications. Adverse events occurring after administration of any vaccine should be reported to the Vaccine Adverse Event Reporting System . Reports can be submitted to VAERS online, by fax, or by mail. Additional information about VAERS is available at .

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Katherine A. Poehling reports institutional support from Safe Sleep for All Newborns, Love Out Loud Early Childhood Fellowship, Intimate Partner Violence Collaborative Project, Because You Matter: Conversations You Want about COVID-19, text messaging follow-up for patients who missed well child visits, and Reimagining Health and Wellness by Mothers for Our Babies, Families, and Communities. H. Keipp Talbott reports institutional grants from the National Institutes of Health. No other potential conflicts of interest were disclosed.

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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

How And When Should You Receive The Hepatitis A Vaccine

You receive the injection of the hepatitis A vaccine in the muscle of your upper arm. Start the vaccine series when you are at risk of infection and at least one month before traveling. You need two doses six to twelve months apart.

There are also combination vaccines for adults that protect against both hepatitis A and hepatitis B. However, these have a different dosing schedule. Ask your doctor for details. You might prefer this option if, for example, you are traveling to countries with high rates of both diseases.

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Persons With Chronic Diseases

Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional general information about vaccination of people with chronic diseases.

Chronic renal disease and patients on dialysis

HA vaccine is recommended for people with chronic renal disease or undergoing dialysis if they are at increased risk of HA infection or severe HA . A study assessing the immune response of hemodialysis patients to standard doses of HA vaccine demonstrated a good HA antibody response and no serious adverse effects.

Chronic liver disease

HA immunization is recommended for susceptible persons with chronic liver disease, including those infected with hepatitis C and chronic HB carriers, because they are at risk of more severe disease if infection occurs. Vaccination should be completed early in the course of the disease, as the immune response to vaccine is suboptimal in advanced liver disease.

Non-malignant hematologic disorders

General Information About Vaccination Outside The Us

In developing countries, the pentavalent vaccine, a combination 5-in-one vaccine that protects against five diseases, diphtheria, pertussis, tetanus, Hib and hepatitis B, may be given to babies more than 6 weeks of age, and can be given up to 1 year of age. The first dose is given at 6 weeks, and the second and third doses are given at 10 and 14 weeks of age. The pentavalent vaccine may be made available free of charge with the support of GAVI, the vaccine alliance. Check the GAVI country hub to see the resources and immunizations that may be available:

For babies born to mothers with hepatitis B, waiting for the first dose of the pentavalent vaccine is too late and will NOT protect the baby from vertical or horizontal transmission of hepatitis B. Babies born to a mother with hepatitis B have a greater than 90% chance of developing chronic hepatitis B if they are not properly treated at birth.

WHO recommends the hepatitis B vaccine within 24 hours of birth for ALL babies. Plan ahead and inquire about the availability and cost of the monovalent , birth dose of the vaccine, as it is not a GAVI provided immunization. This is particularly important to women who are positive for hepatitis B.

If you are unsure of your hepatitis B status, please be sure your doctor tests you for hepatitis B!

*WHO does not recommend a birth dose of HBIG, which may not be available in all countries. Talk to your doctor if you have questions.

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Who Should Receive Hepatitis B Vaccination

• All newborns before hospital discharge. Infants born to hepatitis B-positive women need hepatitis B vaccine and HBIG within 12 hours of birth.
• All children and adolescents not previously vaccinated.
• Children born in the U.S. to individuals born in a country with high hepatitis B endemicity.
• All individuals at risk of hepatitis B infection:
• Sex partners of hepatitis B-positive persons
• Sexually active persons who are not in a long-term, mutually monogamous relationship
• Persons seeking evaluation or treatment for a sexually-transmitted disease
• Men who have sex with men
• Persons who inject drugs
• Household contacts of hepatitis B-positive persons
• Persons born in countries where hepatitis B infection is endemic should be tested and vaccinated if susceptible
• International travelers to regions with high or intermediate rates of endemic hepatitis B infection
• Health care and public safety workers that may be exposed to blood or blood-contaminated body fluids
• Residents and staff of facilities for developmentally disabled persons, corrections facilities, and other facilities that serve adults at risk for hepatitis B infection
• Persons with end-stage renal disease, including pre-dialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
• Persons with chronic liver disease
• Persons to age 60 years with diabetes
• Persons with HIV infection

• All other persons seeking protection from hepatitis B infection.

Advisory Committee On Immunization Practices Recommendations

In February 2018, ACIP approved recommendations for Heplisav-B vaccine as an option for previously unvaccinated or incompletely vaccinated persons, including:

• Adults 18 years of age and older who have a specific risk, or lack a risk factor but want protection. See ACIP Recommended Immunization Schedule for Adults for risk factors.

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Technically Speaking: Hepatitis B Vaccination For Adults Who Needs It And When

Hepatitis B vaccination recommendations vary by a persons age and risk factors. In the Technically Speaking column in August, we discussed routine hepatitis B vaccination of infants, children and teens. This month, lets review hepatitis B vaccination of adults, including vaccination guidance for high-risk groups. In an upcoming column, we will review the issues surrounding hepatitis B serologic tests and vaccination, including who needs testing and when.

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:

• A desire for protection from hepatitis B in people who have not been previously vaccinated

• 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

• HIV infection

• 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

• 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.

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Indications For Hepatitis A Vaccine

HepA vaccine also is indicated when any of the following is present:

• A desire for protection from hepatitis A in people not previously vaccinated

• Travel to or work in endemic areas

• Occupational exposure

• Sex between men

• Use of illicit drugs , such as methamphetamine

• Homelessness

• HIV infection in all people 1 year of age

• A chronic liver disorder

• Anticipated close personal contact with an adopted child during the first 60 days after the child’s arrival in the US from an endemic area

• Healthy adults 40 years who have recently been exposed to hepatitis A virus and adults > 40 if hepatitis A immunoglobulin cannot be obtained

• Pregnant women who are identified to be at risk of HAV infection during pregnancy or who are at risk of having a severe outcome resulting from HAV infection

During hepatitis A outbreaks, people 1 year of age who are at risk of HAV infection should be vaccinated.

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.

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.

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