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 DosesScheduleDose
Children
age 2 to 18 years
20 and 6 to 12 months720 ELISA units (0.5 mL)
Adults 18 years and older20 and 6 to 12 months1440 ELISA units (1.0 mL)
* Inactivated vaccine. Manufactured by SmithKline Beecham Biologicals.

VAQTA**

Age# of DosesScheduleDose
Children
age 2 to 17 years
20 and 6 to 18 months25 units (0.5 mL)
Adults 17 years and older20 and 6 months50 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.

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 DosesScheduleDose
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 mother3Hepatitis B immune globulin and vaccination within 12 hours of birth, then vaccine at 1 to 2 and 6 months5.0 µg
(0.5 mL)
10 µg
(0.5 mL)
Children and adolescents age 1 to 19 years30, 1 to 2, and 4 to 6 months5.0 µg
(0.5 mL)
10 µg
(0.5 mL)
Adolescents
11 to 15 years
20 and 4 to 6 months10 µg
(1.0 mL)
N/A
Adults 20 years and older30, 1 to 2, and 4 to 6 months10 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 adults40, 1, 2, and 6 monthsN/A40 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.

ExposureTreatment
Perinatal1 dose of HBIG given with the first hepatitis B vaccine dose.
Percutaneous or permucosalHBIG and vaccination depending on vaccination and exposure status.
SexualHBIG with or without vaccination for exposure to acute hepatitis B; vaccination alone for chronic exposure.
Household contactHBIG 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).

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