Hepatitis Vaccination Guidelines for Healthy Adults

Hepatitis B Vaccination Schedule

The American College of Physicians recommends a 2-dose Heplisav-B regimen (20 μg at 0 and 1 month) for adults ≥18 years, providing faster protection with fewer visits 1, 2
The Centers for Disease Control and Prevention suggests a traditional 3-dose series of Recombivax HB 10 μg or Engerix-B 20 μg administered at 0, 1, and 6 months for adults ≥20 years 1, 3
After the first dose, only 30-55% achieve protective antibody levels; after the second dose, 75% are protected; after the third dose, >90% achieve protection 3
Vaccine-induced immunity persists for >30 years, and routine booster doses are not needed in immunocompetent adults 3

The Infectious Diseases Society of America recommends single-antigen vaccines as a 2-dose series: Havrix at 0 and 6-12 months, or Vaqta at 0 and 6-18 months 4, 5, 6
The first dose provides substantial protection, but the second dose is essential for long-term immunity 4, 6
Any person seeking protection from hepatitis A virus infection should be vaccinated—identification of specific risk factors is not required 6, 7

The Advisory Committee on Immunization Practices suggests Twinrix can be administered as a 3-dose series at 0, 1, and 6 months for adults ≥18 years seeking protection against both hepatitis A and B 4, 5, 1
An accelerated 4-dose schedule is available for those requiring rapid protection: doses at 0 days, 7 days, 21-30 days, and a booster at 12 months 4, 5, 1, 2

Pre-vaccination serologic testing is not required and should not be a barrier to vaccination in healthy adults 1
Post-vaccination testing for hepatitis B is not routinely needed in healthy immunocompetent adults, as >90% achieve protective antibody levels after completing the series 3
Do not restart the vaccination series if doses are delayed—there is no maximum interval between doses; simply continue the schedule 1, 2
Do not use Heplisav-B or PreHevbrio in pregnant women, as these vaccines lack sufficient safety data in pregnancy; use Engerix-B, Recombivax HB, or Twinrix instead 1, 2