hepatitis-b-vaccine-for-adults-schedule

LATEST HEPATITIS B VACCINE FOR ADULTS SCHEDULE VS KIDS’ ; It’s here

Hepatitis B vaccine for adults schedule, is more of value in today’s time than it was ever in past. Every person at some point in time is at some risk to get Hepatitis B. And if something as simple as taking few shots of vaccine can prevent it, then why not!!!

As more and more people are digging through internet to find out schedule of hepatitis b vaccine, we thought to compile it all for all age groups. Further the special schedule for people with low immunity is also briefed here.  

 

What is hepatitis B vaccine ?

Hepatitis B vaccine prevents against hepatitis B virus infection. The Hepatitis B virus may cause incurable disease in human. This disease has high chances of progressing to liver dysfunction and failure. 

A layman might not know how common hepatitis B infection is! Countless people are currently living with chronic hepatitis B disease. It is transmitted through blood, blood products or body fluid. 

A person can get hepatitis B by unsafe sex, unsafe injection, and sometimes tattoo needles also. Not only that, you will be stunned to know that even sharing tooth brush, comb, shaving blades or trimmers can transmit this deadly disease. Mother to baby transmission can occur at birth. 

Important note

Hepatitis B is not spread by touching or shaking hands with an infected person. It is not propagated through food or water. 

What does hepatitis b vaccine protect against ?

In our previous post, we have already disclosed how hpv vaccine ( human papilloma virus vaccine ) prevents against cervix cancer in females and many other cancers in males. But the first vaccine that was found out to have anti cancer activity is hepatitis B vaccine. 

Yes, you heard it right. Hepatitis b vaccine prevents against liver cancer. Not only that, it also keeps a person safe from liver failure and permanent scarring of liver that may happen because of hepatitis b virus infection.

Who are the candidates eligible for receiving hepatitis b vaccine?

There are millions of people living with chronic hepatitis B. And the sad reality is majority of them don’t know that they are carrying infection. These people transmit infection to others. That’s why importance of hepatitis B vaccine comes into play. 

Since year 1991 hepatitis vaccine at birth is made compulsory for all babies ( unless there is definite contraindication to it. So a good deal of people who are born after 1991 are protected with vaccine. But what about those adults who are not yet vaccinated? 

What is CDC recommendation for hepatitis b vaccine for adults schedule ? And most importantly who are the ones who stands in need of this vaccine? 

Before going to hepatitis b vaccine for adults schedule let us find out who are the candidates eligible to take this vaccine. Following people should be vaccinated against hepatitis b vaccine. 

  1. Infants and children less than 19 years age
  2. All adults between 19 to 59 years age who are not previously vaccinated 
  3. >60 years olds at high risk of getting hepatitis infection, and who are not previously vaccinated. 
  4. >60 years who doesn’t have any risk factor but are eager to get vaccinated 

So, above criteria covers a broad range of population, isn’t it!!! This is so because, every person is at some risk of getting exposed to hepatitis b infection at some point in time. 

What are the high risk factors for Hepatitis B vaccine?

Below we have pointed out those high risk factors which predisposes a person to get hepatitis b infection. 

 

  1. Person who has HBsAg positive partner.
  2. An individual not in monogamous relationship ( i.e. who have more than one partner in 6 months ) 
  3. Men who have sex with men
  4. A person who is taking treatment for sexually transmitted disease 
  5. Close household family members of HBsAg positive individuals 
  6. People employed in health care sector
  7. Public safety workers exposed to blood or body products 
  8. Staff of institutions dealing with developmentally disabled people 
  9. I.V. drug abusers 
  10. People receiving frequent blood transfusions 
  11. Baby born to HBsAg positive mother
  12. People living in countries where hepatitis b is endemic ( > or = 2% of population are HBsAg ) 
  13. A person carrying hepatitis C virus inside
  14. Person with HIV 
  15. People living with diabetes 
  16. Those who are on dialysis for CKD ( chronic kidney disease ) or are at predialysis stage 
  17. People who are sickened with chronic liver disease 
  18. Incarcerated persons 

Whom should not be given hepatitis b vaccine?

Following people should not be given hepatitis b vaccine 

  1. Person having history of allergy after hepatitis b vaccine in past.
  2. A Person allergic to yeast ( yeast is a fungus used commonly while baking cakes ) 
  3. Moderately to severely ill person
  4. A person who already contracted hepatitis B infection ( because vaccine will not help ) 
  5. Baby less than 2 kg weight

BRANDS USED IN HEPATITIS B VACCINE FOR ADULTS SCHEDULE

Monovalent Hepatitis B vaccines mentioned above protect against only Hepatitis B infection. 

hepatitis-b-vaccine-2-dose

Brands of monovalent Hepatitis B vaccine available

This has a strength of 20 microgram antigen per 1 ml. 

It is obtainable in 2 strengths. First one has 10 microgram antigen per 1 ml. Additionally there is a Recombivax HB dialysis formulation as 40 microgram per 1 ml. 

Special hepatitis B vaccines

There are 2 other special hepatitis B vaccines Heplisav B ( by Dynavax ) and Prehevbrio ( from VBI vaccine ) which are recommended only in adults >or = 18 years of age. Details of both is discussed later on, in this blog. 

Hepatitis B vaccine is also available as combination vaccine which provide protection for other diseases too, along with hepatitis B. The combination brands approved to be used in hepatitis b vaccine for adults schedule are enumerated below. 

hepatitis-b-vaccine-adult-dose

Brands of combination vaccines available for hepatitis b

 

It is a combination vaccine for both hepatitis B and Hepatitis A. It is sanctioned for use only in adults > 18 years age. 

This is actually a combination of DTaP + Hep B + IPV. Hence it is a pentavalent vaccine, that provide protection against 5 diseases. These are Diptheria, Tetanus, Pertusis, Hepatitis B and Polio. Pediarix is authorised for use in babies > or = 6 weeks. 

It has DTaP + Hep B + IPV + Hib. It is a hexavalent vaccine. It safeguards against 6 diseases namely Diptheria, Pertusis, Tetanus, Hepatitis B, Polio, Harmophilus influenza B. Same like Pediarix, this is also approved for > or = 6 week old babies. 

 

What is route of hepatitis b vaccine in adults and in children?

Hepatitis b vaccine is injected into muscle. As per CDC, preferred site for newborn and infant ( i.e for less than 1 year olds ) is mid thigh. for toddlers and young children it can jabbed into mid thigh as well as upper arm, provided muscle mass in upper arm is adequate. For adolescents and adults vaccine should be given into upper arm muscle ( i.e deltoid muscle ). 

Important note

Vaccine should on no occasion be injected into buttocks. Because immunity generated through this site is poor and unpredictable. 

What is hepatitis b vaccine for adults schedule

3 dose schedule

Hepatitis b vaccine for adults schedule, that most commonly followed is a 3 dose schedule. 

 

Dose 

Time of injection at

1st dose

0 months

2nd dose

1-2 months

3rd dose

4-6 months

Whatever the schedule is, least possible interval between first and second dose should be 1 month. Gap between 2nd and 3rd dose ought to be at least 2 months and 1st and 3rd dose is at least 4 months. 

However customarily followed schedule for an immuno-competent adult ( adult with strong immunity) is a 3 dose schedule at 0,1 and 6 months. 

4 dose schedule

For immuno-deficient adults and person having chronic kidney disease on dialysis, 4 dose schedule is accepted universally. As per this 4 doses are given at 0,1,2 and 6 months. The dose of hepatitis B vaccine is in fact a double dose (40 microgram ) as we have discussed earlier. 

2 dose schedule of hepatitis b vaccine?

At present this new 2 dose hepatitis B vaccine for adults schedule, is gaining popularity. This is called 2 dose schedule, as a person just needs to take 2 doses at 1 month ( 4 weeks ) interval as a complete schedule. No more booster dose is needed. Compliance is really good with 2 dose schedule. 

The vaccine that is certified for 2 dose schedule is Heplisav B ( Dynavax ). Age of person taking 2 dose vaccine should be > or = 18 years of age. 

What is schedule of hepatitis b vaccine for a child ?

Birth dose :

Hepatitis B vaccine at birth is mandatory for all babies, provided baby is > or = 2 kg and is not too sick. This birth dose got to be given within 24 hours of delivery. 

If baby is born to mother who is already infected with Hepatitis B, then baby must be vaccinated within 12 hours of delivery with Hepatitis B vaccine. Along with HBIG ( Hepatitis B immunoglobulin ) should be given at a separate injection site. 

 

Complete schedule :

Following birth dose, baby should be administered at least 2 or 3 more doses of Hepatitis B vaccine to complete its schedule and provide lifelong protection. Hereunder are the schedule options.

  • 0, 1 month and 6 months
  • 0, 6 weeks and 6 months
  • 0, 6 weeks, 10 weeks, 14 weeks
  • 0, 6 weeks, 14 weeks

Vaccine of hepatitis B at 6 week or 10 week or 14 week is given as combination vaccines along with other vaccines. For example pentavalent vaccine is a combination vaccine which defends against 5 different diseases that include hepatitis B too. Likewise hexavalent vaccine protect from 6 different diseases including hepatitis B. 

Regardless, birth dose of hepatitis B is always a monovalent vaccine i.e. it has only hepatitis B antigen. 

 

By giving combination vaccines, compliance and ease of giving vaccine increases and number of hospital visits cuts down to minimum. 

Accelerated schedule :

When mother is HBsAg positive then the vaccine schedule followed for baby is also the same. As we discussed previously, along with birth dose of hepatitis B vaccine, baby should additionally receive Hepatitis B immunoglobulin. 

However if somehow baby misses out on HBIG ( Hepatitis B immunoglobulin ) at birth, and instead only vaccine is given, then accelerated schedule of 0,1,2 and 6 months is followed. 

Conclusion

The best thing about internet is, it is a vast ocean of knowledge. And the right kind of knowledge is all-important here. This article is a small effort to spread this knowledge as much as possible in community. Share this article if you really found it helpful and informative. 

Caution

All the informations provided here are for educational and awareness purpose only. Kindly do not use these as alternative to medical consultation.

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