The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis B (HepB) vaccination among all infants at birth, unvaccinated children younger than 19 years of age, adults aged 19–59 years, and adults aged 60 years and older with risk factors for hepatitis B or without identified risk factors but seeking protection.
ACIP recommends that the following people should receive hepatitis B (HepB) vaccination:
The following groups may also receive HepB vaccination:
The table below provides recommendations for screening, testing, and vaccination for adults and all persons with risk. Testing should not be a barrier to vaccination of susceptible people, especially in populations that have less engagement with or access to health care. In settings where testing is not feasible or is refused by the patient, the clinician should offer vaccination and, at future visits, should offer testing again.
Population
Screening and testing recommendation
Vaccination recommend ation
Adults with no known risk factors for hepatitis B
People with risk factors , regardless of age. *
People with additional risk factors, such as:
* For additional considerations for patients on dialysis, see Footnote A A .
† For additional considerations for healthcare personnel see Footnote B B .
§ Vaccinate susceptible persons without documentation of a completed hepatitis B vaccination series; testing should not be a barrier to vaccination.
For testing recommendations and assistance interpreting B screening results, see hepatitis B testing guidelines.
The United States Food and Drug Administration (FDA) has licensed three single-antigen vaccines (Engerix-B, Heplisav-B, and Recombivax HB), one three-antigen vaccine (PreHevbrio), and three combination vaccines (Pediarix, Vaxelis, and Twinrix) to protect against hepatitis B. All vaccines contain yeast protein and aluminum adjuvant or a small synthetic immunostimulatory (Heplisav-B).
People aged 19 years and younger should receive three doses. People aged 20 years and older should receive three doses. Adults on hemodialysis should receive four doses. See package insert for detailed dosage instructions.
See Also: Engerix-B Package InsertPeople aged 18 years and older should receive two doses. Data on Heplisav-B are currently insufficient to inform vaccine-associated risks in pregnancy. Thus, providers should vaccinate pregnant people needing HepB vaccination with Engerix-B, Recombivax HB, or Twinrix.
See Also: Heplisav-B Package InsertPeople aged 19 years and younger should receive three doses. People aged 20 years and older should receive three doses. See package insert for detailed dosage instructions.
See Also: Recombivax HB Package InsertPeople aged 18 years and older should receive three doses. Data on PreHevbrio are currently insufficient to inform vaccine-associated risks in pregnancy. Providers should use Engerix-B, Recombivax HB, or Twinrix for HepB vaccinations during pregnancy.
See Also: PreHevbrio Package Insert)People between 6 weeks and 6 years of age should receive three doses. See package insert for detailed dosage instructions.
See Also: Pediarix Package InsertPeople between 6 weeks and 4 years of age should receive three doses. See package insert for detailed dosage instructions.
See Also: Vaxelis Package InsertPeople aged 18 years and older should receive either three or four doses. See package insert for detailed dosage instructions.
See Also: Twinrix Package InsertEach of the HepB vaccines are highly effective in preventing infection. Studies indicate that immunity persists for at least 30 years among healthy people who initiate HepB vaccination at less than 6 months of age.
Scientific evidence overwhelmingly supports the safety of HepB vaccines.
As a precaution, clinicians should ask the person getting the vaccine if they've previously experienced an allergic reaction to:
People who are moderately or severely ill should wait until they recover before getting a HepB vaccine. However, administering the vaccine to people with minor illnesses, such as a cold, is fine. Learn more about contraindications and precautions.
The most frequently reported adverse event associated with HepB vaccination is injection site soreness. Any adverse event suspected to be associated with HepB vaccination should be reported through the Vaccine Adverse Event Reporting System (VAERS).
VAERS is an early warning system, co-managed by CDC and the FDA, that monitors potential vaccine safety problems. Clinicians and vaccine manufacturers are required by law to report certain adverse events following vaccination to VAERS. Patients and caregivers can also submit reports.
Clinicians should administer the vaccine intramuscularly into the anterolateral aspect of the thigh or the deltoid muscle of the upper arm, depending on the person’s age. When administering multiple vaccines, Clinicians should use different anatomic sites (e.g., separate limbs).
Clinicians can administer HepB vaccine concurrently with other vaccines to children and adults. There is no evidence that coadministration reduces the vaccine response or effectiveness.
HepB vaccine can be given as a stand-alone vaccine or as part of a combination vaccine. For detailed information on HepB vaccine schedules, see immunization schedule for children or immunization schedule for adults.
Vaccine Information Statements (VISs) are information sheets produced by CDC that explain both the benefits and risks of a vaccine. View the VIS for HepB vaccine .
