Hepatitis B Pediatric Vaccine Dosage

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Usual Pediatric Dose for:

Additional dosage information:

Usual Pediatric Dose for Hepatitis B Prophylaxis

Engerix-B:
Infants born of HBsAg positive mothers: 0.5 mL (10 mcg) IM at 0, 1 and 6 months.
Alternate dose: 0.5 mL (10 mcg) IM at 0, 1, 2, and 12 months. Hepatitis B immune globulin should be given at the same time as the first dose of vaccine (in the opposite thigh).

Infants born of HBsAg negative mothers: 0.5 mL (10 mcg) IM at 0, 1, and 6 months.

0 to 19 years: 0.5 mL (10 mcg) IM at 0, 1, and 6 months.

Alternate dose:
0 to 10 years (with recent exposure to the virus or certain travelers to high-risk areas): 0.5 mL (10 mcg) IM at 0, 1, 2, and 12 months.
5 to 16 years: 0.5 mL (10 mcg) IM at 0, 12, and 24 months.
11 years or older (with recent exposure to the virus or certain travelers to high-risk areas): 1 mL (20 mcg) IM at 0, 1, 2, and 12 months.


Recombivax HB:
Infants born of HBsAg positive mothers: 0.5 mL (5 mcg) IM at 0, 1, and 6 months. Hepatitis B immune globulin should be given at the same time as the first dose of vaccine (in the opposite thigh).

Infants born of HBsAg negative mothers: 0.5 mL (5 mcg) IM at 0, 1, and 6 months.

0 to 19 years: 0.5 mL (5 mcg) at 0, 1, and 6 months.

Alternate dose:
11 to 15 years: 1 mL (10 mcg) at 0 and 4 to 6 months.

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

No adjustment recommended.

Precautions

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(R) 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.

Dialysis

Data not available

Other Comments

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 anterolateral thigh is recommended for children. 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.

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