Formulary
Hepatitis B Vaccine: Indications, Dosing, Side Effects and Interactions
B vaccine Hepatitis B vaccine is an inactivated vaccine containing adsorbed hepatitis B surface antigen.
MedNext Academy | 7 min read
Hepatitis B Vaccine: Indications, Dosing, Side Effects and Interactions
B vaccine Hepatitis B vaccine is an inactivated vaccine containing adsorbed hepatitis B surface antigen.
Drug action
B vaccine Hepatitis B vaccine is an inactivated vaccine containing adsorbed hepatitis B surface antigen.
Indications and dose
**Immunisation against hepatitis B infection for Engerix B**
- **Neonate** (By intramuscular injection): 10 micrograms for 1 dose, then 10 micrograms after 1 month for 1 dose, followed by 10 micrograms after 5 months for 1 dose, this dose should not be given to neonates born to hepatitis B surface antigen-positive mothers.
- **Child 1 month-15 years** (By intramuscular injection): 10 micrograms for 1 dose, then 10 micrograms after 1 month for 1 dose, followed by 10 micrograms after 5 months for 1 dose.
- **Child 16-17 years** (By intramuscular injection): 20 micrograms for 1 dose, then 20 micrograms after 1 month for 1 dose, followed by 20 micrograms after 5 months for 1 dose.
**Immunisation against hepatitis B infection (accelerated schedule for pre- and post-exposure prophylaxis) for Engerix B**
- **Neonate** (By intramuscular injection): 10 micrograms every month for 3 doses, followed by 10 micrograms after 10 months for 1 dose, for post-exposure prophylaxis, UKHSA advises dose at 12 months not required if patient is at low risk, this dose should not be given to neonates born to hepatitis B surface antigen-positive mothers.
- **Child 1 month-15 years** (By intramuscular injection): 10 micrograms every month for 3 doses, followed by 10 micrograms after 10 months for 1 dose, for post-exposure prophylaxis, UKHSA advises dose at 12 months not required if patient is at low risk.
- **Child 16-17 years** (By intramuscular injection): 20 micrograms every month for 3 doses, followed by 20 micrograms after 10 months for 1 dose, for post-exposure prophylaxis, UKHSA advises dose at 12 months not required if patient is at low risk.
**Immunisation against hepatitis B infection (alternative accelerated schedule) for Engerix B**
- **Child 11-15 years** (By intramuscular injection): 20 micrograms for 1 dose, followed by 20 micrograms after 6 months for 1 dose, this schedule is not suitable if high risk of infection between doses or if compliance with second dose uncertain.
**Immunisation against hepatitis B infection (very rapid schedule) for Engerix B**
- **Child 16-17 years** (By intramuscular injection): 20 micrograms for 1 dose, then 20 micrograms after 7 days for 1 dose, followed by 20 micrograms after 14 days for 1 dose, followed by 20 micrograms for 1 dose, to be given 12 months after the first dose.
**Immunisation against hepatitis B infection (in neonates born to hepatitis B surface antigen-positive mothers) for Engerix B**
- **Neonate** (By intramuscular injection): 10 micrograms every 4 weeks for 2 doses, first dose to be given ideally within 24 hours of birth, for neonates with a birth weight below 1.5 kg born to an infected mother, or neonates born to a highly infectious mother, the first dose should be given at birth with hepatitis B immunoglobulin injection (separate site).
**Immunisation against hepatitis B infection (in renal insufficiency, including haemodialysis patients) for Engerix B**
- **Neonate** (By intramuscular injection): 10 micrograms every month for 2 doses, followed by 10 micrograms after 5 months for 1 dose, immunisation schedule and booster doses may need to be adjusted in those with low antibody concentration, this dose should not be given to neonates born to hepatitis B surface antigen-positive mothers.
- **Child 1 month-15 years** (By intramuscular injection): 10 micrograms every month for 2 doses, followed by 10 micrograms after 5 months for 1 dose, immunisation schedule and booster doses may need to be adjusted in those with low antibody concentration.
- **Child 16-17 years** (By intramuscular injection): 40 micrograms every month for 3 doses, followed by 40 micrograms after 4 months for 1 dose, immunisation schedule and booster doses may need to be adjusted in those with low antibody concentration.
**Immunisation against hepatitis B infection (accelerated schedule for pre- and post-exposure prophylaxis in renal insufficiency, including haemodialysis patients) for Engerix B**
- **Neonate** (By intramuscular injection): 10 micrograms every month for 3 doses, followed by 10 micrograms after 10 months for 1 dose, for post-exposure prophylaxis, UKHSA advises dose at 12 months not required if patient is at low risk, immunisation schedule and booster doses may need to be adjusted in those with low antibody concentration, this dose should not be given to neonates born to hepatitis B surface antigen-positive mothers.
- **Child 1 month-15 years** (By intramuscular injection): 10 micrograms every month for 3 doses, followed by 10 micrograms after 10 months for 1 dose, for post-exposure prophylaxis, UKHSA advises dose at 12 months not required if patient is at low risk, immunisation schedule and booster doses may need to be adjusted in those with low antibody concentration.
**Immunisation against hepatitis B infection in renal insufficiency (including pre-haemodialysis and haemodialysis patients) for Fendrix**
- **Child 15-17 years** (By intramuscular injection): 20 micrograms every month for 3 doses, followed by 20 micrograms after 4 months for 1 dose, immunisation schedule and booster doses may need to be adjusted in those with low antibody concentration.
**Immunisation against hepatitis B infection for HBvaxPRO**
- **Neonate** (By intramuscular injection): 5 micrograms for 1 dose, followed by 5 micrograms after 1 month for 1 dose, then 5 micrograms after 5 months for 1 dose, booster doses may be required in immunocompromised patients with low antibody concentration, dose not to be used in neonates born to hepatitis B surface antigen-positive mothers.
- **Child 1 month-15 years** (By intramuscular injection): 5 micrograms for 1 dose, followed by 5 micrograms after 1 month for 1 dose, then 5 micrograms after 5 months for 1 dose, booster doses may be required in immunocompromised patients with low antibody concentration.
- **Child 16-17 years** (By intramuscular injection): 10 micrograms for 1 dose, followed by 10 micrograms after 1 month for 1 dose, followed by 10 micrograms after 5 months for 1 dose, booster doses may be required in immunocompromised patients with low antibody concentration.
**Immunisation against hepatitis B infection (accelerated schedule for pre- and post-exposure prophylaxis) for HBvaxPRO**
- **Neonate** (By intramuscular injection): 5 micrograms every month for 3 doses, followed by 5 micrograms after 10 months for 1 dose, for post-exposure prophylaxis, UKHSA advises dose at 12 months not required if patient is at low risk, booster doses may be required in immunocompromised patients with low antibody concentration, dose not to be used in neonates born to hepatitis B surface antigen-positive mothers.
- **Child 1 month-15 years** (By intramuscular injection): 5 micrograms every month for 3 doses, followed by 5 micrograms after 10 months for 1 dose, for post-exposure prophylaxis, UKHSA advises dose at 12 months not required if patient is at low risk, booster doses may be required in immunocompromised patients with low antibody concentration.
- **Child 16-17 years** (By intramuscular injection): 10 micrograms every month for 3 doses, followed by 10 micrograms after 10 months for 1 dose, for post-exposure prophylaxis, UKHSA advises dose at 12 months not required if patient is at low risk, booster doses may be required in immunocompromised patients with low antibody concentration.
**Immunisation against hepatitis B infection (in neonates born to hepatitis B surface antigen-positive mothers) for HBvaxPRO**
- **Neonate** (By intramuscular injection): 5 micrograms every 4 weeks for 2 doses, first dose to be given ideally within 24 hours of birth, for neonates with a birth weight below 1.5 kg born to an infected mother, or neonates born to a highly infectious mother, the first dose should be given at birth with hepatitis B immunoglobulin injection (separate site).
**Immunisation against hepatitis B infection (in chronic haemodialysis patients) for HBvaxPRO**
- **Child 16-17 years** (By intramuscular injection): 40 micrograms every month for 2 doses, followed by 40 micrograms after 5 months for 1 dose, booster doses may be required in those with low antibody concentration.
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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