Adult Dosing & Uses
Dosing Forms & Strengths
adult vaccine
- 20mcg HbsAg/mL
peds vaccine
- 10mcg/0.5mL
Hepatitis B vaccination
3 dose series
Engerix B (20+ yo)
- 1 mL (20 mcg) IM deltoid at 0, 1, 6 months
- Hemodialysis: 2 mL (40 mcg) at 0, 1, 2, 6 months
- For alternate dosing schedule, see package insert
Recombivax HB (20+ yo)
- 1 mL (10 mcg) IM deltoid at 0, 1, 6 months
- Hemodialysis: 1 mL dialysis vacc (40 mcg) at 0, 1, 6 months
Patients with diabetes mellitus
- CDC ACIP guidelines recommends immunization with hepatitis B vaccine for all unvaccinated adults with diabetes mellitus through age 59 years
- Persons with diabetes are at increased risk of hepatitis B infection
- Vaccination for older unvaccinated diabetic patients may be done at the physician's discretion MMWR Dec 23, 2011/Vol 60(50);1709-11
Administration
Do not give IV/intradermal
Consider booster dose PRN
Other Indications & Uses
Routine immunization against hepatitis B; also protects against hepatitis D which always occurs in the presence of hep B
Infants born to HbsAg+ mothers
Persons with or exposed to:
- chronic liver & end stage renal disease, incl hemodialysis; STDs; HIV infection
- occupational hazards, incl blood or other infectious body fluids
- behavioural risks, incl multiple sex partners, IV drug use
- individuals with chronic hepatitis B & in settings where Hepatitis B vaccination is recommended
- adults diagnosed with diabetes mellitus
Adults receiving hemodialysis and/or immunocompromised adults
Also reduces risk of hepatocellular carcinoma
Additional Information
Up-to-date vaccination schedules available at www.cdc.gov/nip/publications
Pediatric Dosing & Uses
Dosing Forms & Strengths
adult vaccine
- 20mcg HbsAg/mL
peds vaccine
- 10mcg/0.5mL
Hepatitis B vaccination
Engerix B (0-19 yo)
- 0.5 mL peds vacc (10 mcg) IM: 0, 1, 6 mth
- For alternate dosing schedule, see package insert
Recombivax HB (0-19 yo)
- 0.5 mL peds vacc (5 mcg) IM: 0, 1, 6 mth
- For alternate dosing schedule, see package insert
Administration
Deltoid for adolescents, anterolateral thigh preferred for neonates/infants/small children
Do not give IV/intradermal
Consider booster dose PRN
Drug Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967
>10%
Pain (10-29%)
Pruritus (10-29%)
Erythema (10-29%)
Burning (10-29%)
Nodules (10-29%)
Fatigue (15%)
Headache (15%)
Fever (15%)
Vertigo (15%)
1-10%
Lightheadedness
Flushinig
Insomnia
Irritability
Arthralgia
Constipation
Pruritus
Lupus-like syndrome
Lymphadenopathy
Tachycardia
Contraindications & Cautions
Contraindications
Hypersensitivity to yeast
Cautions
Not protective against hepatitis A, C, or E
Gluteal muscle not recommended
Heptavax B (plasma-derived) no longer used in the US
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Pharmacology
Mechanism of Action
Hepatitis B surface antigen (HBsAg) which stimulates active immunity
Duration: not established
Excretion: not established
These products convey active immunity via stimulation of production of endogenously produced antibodies
The onset of protection from disease is relatively slow, but duration is long lasting (years)
