Hepatitis B Adult Vaccine Dosage

Usual Adult Dose for Hepatitis B Prophylaxis

Primary Vaccination:
Engerix-B(R):
Ages 19 and younger: Three doses (10 mcg each), IM, on a 0, 1, and 6 month schedule
Ages 20 and older: Three doses (20 mcg each), IM, on a 0, 1, and 6 month schedule

Recombivax-HB(R):
Ages 19 and younger: Three doses (5 mcg each), IM, on a 0, 1, and 6 month schedule
Ages 20 and older: Three doses (10 mcg each), IM, on a 0, 1, and 6 month schedule

Known or Presumed Hepatitis B Exposure:
Use recommended doses (above) on a 0, 1, and 6 month schedule OR a 0, 1, 2, and 12 month schedule.

Comments:
-Administer hepatitis B immune globulin if appropriate.
-Start hepatitis B vaccine as soon as possible after exposure.

Renal Dose Adjustments

Recombivax HB Dialysis Formulation(R):

Predialysis patients: Three doses (40 mcg each), IM, on a 0, 1, and 6 month schedule

Liver Dose Adjustments

Data not available

Dose Adjustments

Alternate dosing schedules (Engerix-B(R)):
11 to 19 years: 3 doses (20 mcg each), IM, on a 0, 1, and 6 month schedule
11 to 19 years: 4 doses (20 mcg each), IM, on a 0, 1, 2, and 12 month schedule
20 years and older: 4 doses (20 mcg each), IM, on a 0, 1, 2, and 12 month schedule

Booster Vaccinations (when appropriate):
Engerix-B(R):
11 years and older: booster dose is 20 mcg

Recombivax-HB Dialysis Formulation(R):
-Consider a booster dose or revaccination for dialysis/predialysis patients if anti-HB level is less than 10 IU/L one to two months after the final dose.

Dialysis

Hemodialysis:

Recombivax HB Dialysis Formulation(R):
Adults on Hemodialysis: Three doses (1 mL/40 mcg each), IM, on a 0, 1, and 6 month schedule

Engerix-B(R):
Adults on Hemodialysis: Four doses (2 mL/40 mcg each), IM, on a 0, 1, 2, and 6 month schedule

Comments:
-Assess need for a booster dose on an annual basis
-The 2 mL Engerix-B(R) dose can be given as a single dose or two 1 mL injections.

Peritoneal dialysis: Data not available

Other Comments

Administration advice:
-Administer IM; the preferred site is the anterolateral aspect of the thigh in patients under 1 year, and the deltoid muscle for older children and adults.
-Do not administer in the gluteal region: response may be suboptimal.
-Administer subcutaneously only in patients at risk of hemorrhage from IM injections.

Reconstitution/preparation techniques:
-Shake well before use to form a homogenous, turbid white suspension.

IV compatibility:
-Do not mix with any other vaccine or product in the same syringe/vial.

General:
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.