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Vaccination for Hepatitis A and B

November 2001

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!


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).


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

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


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.


Sources

  1. 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).
  2. 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).

The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, this does not mean or imply that the product is unsatisfactory.

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!



  
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This article was provided by U.S. National Institutes of Health. Visit NIH's website to find out more about their activities, publications and services.
 
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