Hepatitis B Adult Vaccine Dosage
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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Hepatitis B Prophylaxis
Engerix-B: 1 mL (20 mcg) IM for 3 doses at 0, 1, and 6 months.
Alternate dose (with recent exposure to the virus or certain travelers to high-risk areas): 1 mL IM for 4 doses at 0, 1, 2, and 12 months.
Recombivax-HB: 1 mL (10 mcg) IM for 3 doses at 0, 1, and 6 months.
Postexposure prophylaxis: Hepatitis B immune globulin should be given as soon as possible after exposure (preferably within 24 hours) along with a dose of hepatitis B vaccine (at a separate site) within 7 days of exposure at 1 and 6 months.
Renal Dose Adjustments
Chronic renal impairment:
less than 20 years: Dialysis and non dialysis patients: 20 mcg/dose
20 years or older: Non dialysis patients: 10 mcg/dose (Recombivax-HB); 20 mcg/dose (Engerix-B)
Dialysis patients: 40 mcg/dose (Recombivax-HB or Engerix-B)
Administer dose at 0, 1 to 2, and 4 to 6 months; repeat dose depending upon annual assessment of hepatitis B surface antigen (anti HB) level; if anti HB is less than 10 mIU/mL, administer an additional dose.
Liver Dose Adjustments
No adjustment recommended.
Hepatitis B vaccine 40 mcg/mL (dialysis formulation) is intended for adult predialysis/dialysis patients only.
Hepatitis B vaccine is contraindicated in patients who have had signs of hypersensitivity after a previous dose of hepatitis B vaccine, or who are allergic to yeast or other trace substances (thimerosal, neomycin) which may be present in some formulations. The cap and plunger of Engerix-B prefilled syringes contain latex, which may cause allergic reactions in sensitive patients.
Hepatitis B has a long incubation period and this vaccine may not prevent infection in persons with unrecognized infection at time of vaccination.
Anaphylaxis may occur, even in patients with no previous hypersensitivity to the vaccine ingredients. Epinephrine and other medications and equipment should be readily available to treat anaphylactic or severe allergic reactions.
Delaying vaccination should be considered if the patient has a moderate or severe acute illness. Minor illnesses such as mild upper respiratory tract infections with or without low grade fever are not considered contraindications to vaccination. Caution is recommended in patients in whom a systemic or febrile reaction would pose a significant risk.
Caution is recommended in patients with thrombocytopenia or coagulation disorders that would contraindicate intramuscular injection.
The expected immune response may not occur in immunosuppressed patients. It may be advisable to defer vaccination for at least 3 months after immunosuppressive therapy.
Hepatitis B vaccine is only intended for intramuscular administration. Injection into a blood vessel should be avoided.
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
Recombivax-HB Dialysis Formulation: 1 mL (40 mcg) 0,1, and 6 months.
Engerix-B: 2 mL (40 mcg) IM for 4 doses at 0, 1, 2, and 6 months
Booster doses should be given when antibody titers decrease to less than 10 million international units/mL.
The vaccine should be refrigerated to maintain potency. Avoid freezing and discard any vaccine that has been frozen.
The vaccine should be shaken well before withdrawing a dose and administering it.
Injection into the deltoid muscle is preferred in adults. Injection into the buttocks may result in a lower seroconversion rate.
Health care providers should report any allergic or unusual adverse reactions to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 (USA) and the manufacturer.
More about hepatitis b adult vaccine
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