Saturday, February 4, 2023

Hepatitis Vaccine Schedule For Adults

International Hepatitis B Vaccine Schedules

Child & Adolescent Immunization, Adult Immunization Schedule and Hepatitis A Vaccine
*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.

The hepatitis B vaccine is an injection that is generally given in the arm and as a three-dose series. The World Health Organization recommends a 0, 1, and 6-month vaccine schedule, though schedules may vary based on a countrys national immunization program. 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. Please note that the vaccine brand name, manufacturer and associated schedules for adults, children and infants may be unique to different countries, though there is a list of WHO prequalified vaccines.

3-Dose Vaccine Series for Infants

The World Health Organization recommends all infants receive the first dose of the hepatitis B vaccine within 24 hours of birth and to complete the vaccine series with additional shots at 1 month and 6 months of age. Beginning the hepatitis B vaccine at birth will ensure protection against hepatitis B for life.

3-Dose Vaccine Series for Children and Adults

4-Dose Combination Vaccine Series for Infants

Additional Resource Links:

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

Are There Any Dangers Or Side Effects Associated With The Vaccine

It’s good to know you cannot become infected by getting the hepatitis A vaccine. But in very rare cases, people can have a severe allergic reaction to the hepatitis A vaccine. This occurs within a few minutes to hours of getting the shot. In extremely rare cases, this reaction can be fatal. It’s important to remember that the risks from the disease are much greater than the risk from the vaccine itself.

Signs of a severe reaction to the hepatitis A vaccination include:

Also Check: How To Cure Hepatitis C Fast

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.

Concurrent Administration Of Vaccines

Recommended Adult Immunization Schedule

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.

Read Also: How To Treat Hepatitis C Virus

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.

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

Read Also: Effects Of Hepatitis B Vaccine

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

Can Hepatitis B Become Negative

ACP 2020 Adult Immunization Update

It can happen, especially in older adults after a long period of inactive hepatitis B infection. About 1 to 3 percent of people with chronic hepatitis B lose HBsAg each year, and about half of all people with chronic infections who live up to age 75 will lose HBsAg, depending on the amount of HBV DNA in their blood.

Read Also: How Do You Get Hepatitis B Or C

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.

Persons New To Canada

Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. In many countries outside of Canada, HB vaccine is in limited use.

All persons from a country that is endemic for HB should be assessed and vaccinated against HB if not immune and not infected. Individuals born in developing countries are more likely to be carriers of HB, necessitating vaccination of their sexual and household contacts based on review of their serologic test results. HB vaccine is recommended for all household contacts whose families have immigrated to Canada from areas in which there is a high prevalence of HB and who may be exposed to HB carriers through their extended families or when visiting their country of origin.

Children adopted from countries in which there is a high prevalence of HB infection should be screened for HBsAg and, if positive, household or close contacts in the adopting family should be immunized before adoption or as soon as possible thereafter. Adults going to pick-up children from these countries should be vaccinated before departure. Refer to Immunization of Persons New to Canada in Part 3 for additional information.

Recommended Reading: What Is The Medicine For Hepatitis B

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

Ref.
Prisoners with intravenous drug use 0 1 6 7
Prisoners with intravenous drug use 0 1/4 3/4 7
Prisoners with intravenous drug use 0 1/4 3/4 7
MSM, IVDU, CSW and STI 0 1 6

*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

Persons With Chronic Diseases

Notice to Readers: Recommended Adult Immunization Schedule

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

People with chronic renal disease may respond sub-optimally to HB vaccine and experience more rapid decline of anti-HBs titres, and are therefore recommended immunization with a higher vaccine dose. Individuals undergoing chronic dialysis are also at increased risk for HB infection. In people with chronic renal disease anti-HBs titre should be evaluated annually and booster doses using a higher vaccine dose should be given as necessary.

Neurologic disorders

People with conditions such as autism spectrum disorders or demyelinating disorders should receive all routinely recommended immunizations, including HB-containing vaccine.

Chronic liver disease

HB immunization is recommended for non-immune persons with chronic liver disease, including those infected with hepatitis C, 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. Post-immunization serologic testing may be used to confirm vaccine response.

Non-malignant hematologic disorders

Persons with bleeding disorders and other people receiving repeated infusions of blood or blood products are considered to be at higher risk of contracting HB and should be offered HB vaccine.

Read Also: Hepatitis C Genotype 1a Treatment

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.

Read Also: Which Hepatitis Affects The Liver

Routine Administration Schedule For Hepatitis B Vaccine In Adults

  • The dosing schedule is 0, 1 to 2 months, and 4 to 6 months.
  • There is some flexibility in the schedule, but be sure to keep in mind the minimum intervals between doses:
    • At least four weeks between doses #1 and #2
    • At least eight weeks between doses #2 and #3
    • At least 16 weeks between doses #1 and #3
  • If your patient falls behind on the hepatitis B vaccination schedule , continue vaccinating from where your patient left off. The series does NOT need to be restarted.

Read Also: Best Juice For Hepatitis B

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.

Page updated September 2022.

How Is Hepatitis B Treated

Hepatitis B Vaccine for Babies – Importance and Recommended Schedule

Immunoglobulin, a passive immunisation, can be administered within 12 hours of an at-risk exposure to help prevent HBV infection. Treatment for chronic disease is through the use of antiviral medications and medications containing naturally-occurring proteins. A liver transplant may be necessary in the event of severe liver damage.

A Hepatitis B vaccination schedule is the best way to prevent infection.

Don’t Miss: Hepatitis C Contagious Through Urine

Testing For Hepatitis B Immunity

Generally a serology result of 10 IU/L is considered immunity to hepatitis B. Vaccinated individuals who have laboratory confirmation of anti-HBs 10 IU/L are considered to have lifetime immunity to hepatitis B even if antibody levels wane to undetectable levels in subsequent serology. This is because an anamnestic immune response will be protective against future hepatitis B exposure.

Refer to the current Immunisation Handbook for information on post-vaccination serology testing and management of non-responders. Non-responders require case-by-case consideration.

A Note About Sex And Gender

Sex and gender exist on spectrums. This article will use the terms, male, female, or both to refer to sex assigned at birth. .

It is important that infants who are born to females with hepatitis B receive accurate doses of the hepatitis B vaccine. They may also be required to receive hepatitis B immunoglobulin if it is available.

The WHO also recommends using antiviral prophylaxis to help prevent hepatitis B transmission.

The table below outlines the two recommended hepatitis B vaccine schedules for infants born to those who have hepatitis B:

Vaccine series

Recommended Reading: Which Hepatitis Is The Worst

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.

Popular Articles
Related news