Recommendation for Immunization:
Hepatitis B Vaccine is recommended for those less than 19 years old and for those 19 or greater who are either at high risk or simply desire protection from the disease. High risk people include those with end-stage kidney disease including hemodialysis patients, people with HIV, people with an STD or being evaluated for one, people with chronic liver disease, men who have sex with other men, people with more than one sex partner per 6 months, people having sex with infected people, people using illegal injected drugs, healthcare and other workers exposed to infected blood or body fluids, household contacts of infected people, and travelers to endemic areas. Other high risk situations exist.

The immunization series consists of 2-3 injections (adolescents may require only 2 if aged 11-15 and receiving the adult dose Recombivax HB®).

• For infants of non-infected mothers: first dose at 0-2 months, second dose 1-4 months of age (at least 1 month after first dose), and third dose at 6-18 months of age.
• For infants of infected mothers: first dose within 12 hours of birth, second dose at 1-2 months of age, and third dose at 6 months of age.
• For adolescents 11-15: 2nd dose 4-6 months after first dose.
• For adults: first dose anytime, second dose 1-2 months after first dose, and third dose 6 months after first dose.

Available brands of this vaccine include:

• Recombivax HB®
• Engerix®
• Twinrix® (combined with Hepatitis A vaccine)
• ComVax® (combined with Haemophilus influenzae type b vaccine)
• Pediarix® (combined with DTaP and inactivated polio vaccine)

This is a vaccine against Hepatitis B.

This vaccine aims to prevent infection with the Hepatitis B virus, a liver infection that occurred in approximately 50,000 people in the United States in 2005. This vaccine can prevent acute and chronic liver infection with the Hepatitis B virus and the liver damage or cancer that this virus can cause. Because it can prevent primary liver cancer that is caused by Hepatitis B, it is considered the first cancer vaccine.

It is usually administered in the deltoid muscle for older children and adults or in the anteriolateral thigh in infants and young children. It can be given subcutaneously for people who are prone to hemorrhage but this can lead to nodules under the skin.

Side effects of the vaccine include soreness at the injection site and mild fever. Fatigue, headache, diarrhea, and sore throat may occur. More severe reactions can occur but are not common. Safety has not been proven in pregnant women or nursing mothers. The pediatric dose is lower than adult dose. Dosing for dialysis and immune compromised patients is even higher. The vaccine also comes in a combined form with Hepatitis A vaccine. Adults can get a combined Hepatitis A and B vaccine (Twinrix®-GlaxoSmithKline), given in 3 doses with the second dose given 1 month after the first dose, and the third dose given 6 months after the first dose. There are also pediatric combined vaccines available for Hepatitis B and Hib (Comvax®-Merck) and for DTaP, Hepatitis B, and Inactivated Polio Vaccine (Pediarix®-GlaxoSmithKline). Comvax® is for children 6 weeks to 4 years and is given at 2, 4, and 12-15 months of age. Pediarix® is for children 6 weeks to 6 years and is given at 2, 4, and 6 months of age.

Most people develop good immunity from this vaccine. Certain people need to be tested for immunity 1-2 months after the last vaccine dose. Those who may need to be tested for immunity are immunocompromised patients, hemodialysis patients, infants born to mothers who have Hepatitis B surface antigen in their blood, healthcare workers in contact with blood products, and people engaging in sex with infected persons. A person is considered immune if the blood shows a level of at least 10 milliinternational units of antibody to Hepatitis B surface antigen.

People with a history of life-threating allergy to baker's yeast should not have this vaccine. Individuals with prior severe reactions to this vaccine may not be able to receive another dose. Check with your doctor regarding this issue and for any other contraindications for this vaccine. Also check with your doctor to find out what other ingredients may be in the vaccine, its container, or any diluent in case of allergies or other concerns. Immunization is usually postponed for individuals with a moderate or severe acute illness.

• Infants, children, and adolescents
• Healthcare and other workers in contact with blood and body fluid products.
• HIV patients
• Chronic liver disease
• Sex with infected person; men having sex with men; individuals with >1 sex partner in 6 months
• Blood transfusions
• Dialysis patients
• Use of contaminated needles for drug use, acupuncture, or tattoos
• Being born to an infected mother.
• International travelers and military personnel
• Prisoners
• Residents and staff of institutions for mentally disabled
• People with Hepatitis C
• People from endemic areas
• Pacific Islanders
• Alaskan natives