Vaccinations for Hepatitis A and B

On this page:

• Candidates for Hepatitis A Vaccination
• Doses and Schedules: Hepatitis A
• Candidates for Hepatitis B Vaccination
• Doses and Schedules: Hepatitis B
• Additional Information
• References

Candidates for Hepatitis A 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)

Doses and Schedules: Hepatitis A

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.

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

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 (0.5 mL)	10 (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 (0.5 mL)	10 (0.5 mL)
Children and adolescents age 1 to 19 years	3	0, 1 to 2, and 4 to 6 months	5.0 (0.5 mL)	10 (0.5 mL)
Adolescents 11 to 15 years	2	0 and 4 to 6 months	10 (1.0 mL)	N/A
Adults 20 years and older	3	0, 1 to 2, and 4 to 6 months	10 (1.0 mL)	20 (1.0 mL)
Immuno- compromised adults	3	0, 1, and 6 months	40 (1.0 mL)	N/A
	4	0, 1, 2, and 6 months	N/A	40 (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.