Vaccinations for Hepatitis A and B

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Candidates for Hepatitis A Vaccination

Routine Vaccination
  • Children living in areas with high incidence rates of hepatitis A (above the national average). Check with your health department to see if this applies to your area.

High-Risk Populations

  • Travelers to developing countries with high rates of hepatitis A, including Mexico
  • Men who have sex with men
  • Users of illegal drugs
  • People who work with hepatitis A virus in research settings
  • People who work with infected nonhuman primates
  • Recipients of clotting factor concentrates
  • People with chronic liver disease (because of risk of fulminant hepatitis A)
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Doses and Schedules: Hepatitis A

HAVRIX*
Age # of Doses Schedule Dose
Children age 2 to 18 years 2 0 and 6 to 12 months
 720 ELISA units (0.5 mL)
Adults 18 years and older 2 0 and 6 to 12 months 1440 ELISA units (1.0 mL)

* Inactivated vaccine. Manufactured by SmithKline Beecham Biologicals.

VAQTA**
Age # of Doses Schedule Dose
Children
age 2 to 17 years		 2 0 and 6 to 18 months 25 units (0.5 mL)
Adults 17 years and older 2 0 and 6 months 50 units (1.0 mL)

** Inactivated vaccine. Manufactured by Merck & Company, Inc.

Postexposure Prophylaxis

Immune globulin is more than 85 percent effective in preventing hepatitis A virus infection when given within 2 weeks of exposure to the hepatitis A virus. The dose is 0.02 mL/kg injected into the gluteal muscle in adults or the anterolateral thigh muscle in children under 2 years. Concurrent hepatitis A vaccination may also be appropriate in people 2 years and older.

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Candidates for Hepatitis B Vaccination

Routine Vaccination

  • All infants, children, and adolescents

High-Risk Populations

  • People with multiple sex partners and those who have been recently diagnosed with a sexually transmitted disease
  • Sex partners and household contacts of HBV carriers
  • Men who have sex with men
  • Household contacts of adoptees from countries with high rates of hepatitis B
  • Injection drug users
  • Travelers to countries with high rates of hepatitis B (staying longer than 6 months)
  • People with occupational exposure to blood
  • Clients and staff in institutions for the developmentally disabled
  • Patients with chronic kidney failure (including those on chronic hemodialysis)
  • Patients receiving clotting factor concentrates
  • Inmates of long-term correctional facilities
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Doses and Schedules: Hepatitis B

Age # of Doses Schedule Dose
Recombivax HB*		 Dose Energix-B**
Infants with HBsAg-negative mother
 3
 0 to 2, 1 to 4, and 6 to 18 months
 5.0 mu
(0.5 mL)		 10 mu
(0.5 mL)
Infants with HBsAg-positive mother 3 Hepatitis B immune globulin and vaccination within 12 hours of birth, then vaccine at 1 to 2 and 6 months 5.0 mu
(0.5 mL)		 10 mu
(0.5 mL)
Children and adolescents age 1 to 19 years 3 0, 1 to 2, and 4 to 6 months 5.0 mu
(0.5 mL)		 10 mu
(0.5 mL)
Adolescents 11 to 15 years 2 0 and 4 to 6 months 10 mu
(1.0 mL)		 N/A
Adults 20 years and older 3 0, 1 to 2, and 4 to 6 months 10 mu
(1.0 mL)		 20 mu
(1.0 mL)
Immuno- compromised adults 3
 0, 1, and 6 months
 40 mu
(1.0 mL)		 N/A
Immunocomprimised adults 4 0, 1, 2, and 6 months N/A 40 mu
(2.0 mL)

Note: There should be at least 1 month between the first and second doses, at least 2 months between the second and third doses, and at least 4 months between the first and third doses. For infants, the third dose should not be given before 6 months of age.

*Recombinant vaccine. Manufactured by Merck & Company, Inc.
**Recombinant vaccine. Manufactured by SmithKline Beecham Biologicals.

Postexposure Prophylaxis

Prophylactic treatment for exposure to hepatitis B virus involves either hepatitis B immune globulin (HBIG), hepatitis B vaccine, or a combination of both. The HBIG dose equals 0.06 mL/kg. Efficacy ranges from 70 to 95 percent for different types of exposure.

Exposure Treatment
Perinatal 1 dose of HBIG given with the first hepatitis B vaccine dose.
Percutaneous or permucosal HBIG and vaccination depending on vaccination and exposure status.
Sexual HBIG with or without vaccination for exposure to acute hepatitis B; vaccination alone for chronic exposure.
Household contact HBIG with vaccination for acute hepatitis B in infants under age 12 months; vaccination alone for chronic.

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Additional Information

For information about Twinrix, the combination vaccine for hepatitis A and B, see the Food and Drug Administration website at www.fda.gov/bbs/topics/ANSWERS/2001/ANS01084.html.

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References

Centers for Disease Control and Prevention. (1999). Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report 48(RR-12).

Centers for Disease Control and Prevention. (1991). Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report 40(RR-13).