Hepatitis B Vaccination Guidelines
Introduction to Hepatitis B Vaccination
- The Centers for Disease Control and Prevention recommends administering Recombivax HB 10 μg (1.0 mL) or Engerix-B 20 μg (1.0 mL) in a 3-dose series at 0, 1, and 6 months for adults ≥20 years 1
- The American Academy of Pediatrics recommends administering 5 μg (0.5 mL) of Recombivax HB or 10 μg (0.5 mL) of Engerix-B in a 3-dose series starting at birth for infants 1
Adult Dosing (≥18 years)
- The Centers for Disease Control and Prevention recommends Recombivax HB 10 μg (1.0 mL) per dose for adults ≥20 years, administered at 0, 1, and 6 months 1, 2
- The Centers for Disease Control and Prevention recommends Engerix-B 20 μg (1.0 mL) per dose for adults ≥20 years, administered at 0, 1, and 6 months 1, 2
- Alternative schedules of 0, 1, 4 months or 0, 2, 4 months produce equivalent seroprotection rates 1
Infant Dosing (<1 year)
- The American Academy of Pediatrics recommends administering the first dose of hepatitis B vaccine within 24 hours of birth for all medically stable infants ≥2,000 grams born to HBsAg-negative mothers 4
- The American Academy of Pediatrics recommends administering the first dose of hepatitis B vaccine within 12 hours of birth plus HBIG (0.06 mL/kg) for infants born to HBsAg-positive mothers 1, 3
- The final dose must not be administered before 24 weeks (164 days) of age 4, 3
Special Populations
- The Centers for Disease Control and Prevention recommends Recombivax HB 40 μg (1.0 mL) dialysis formulation at 0, 1, and 6 months for hemodialysis and immunocompromised patients ≥20 years 1, 2
- The Centers for Disease Control and Prevention recommends Engerix-B 40 μg (2.0 mL—two 1.0 mL doses at one site) at 0, 1, 2, and 6 months for hemodialysis and immunocompromised patients ≥20 years 1, 2
- Annual anti-HBs testing is recommended with booster when <10 mIU/mL for hemodialysis and immunocompromised patients ≥20 years 3