Who Should Receive a Hepatitis B Immunization?

Hepatitis B vaccine indications for adults and children

Adults

In adults, the hepatitis B vaccine is administered in intramuscular suspensions of 10, 20, or 40 mcg/mL or intramuscular solutions with an adjuvant formulation. Routine immunization can be performed in two or three injections. When Recombivax HB (10 mcg/mL) or Engerix B (20 mcg/mL) is used, the first 1 mL shot should be followed by a second shot after 1 month and the third shot after 6 months. When the adult adjuvanted formulation is used (Heplisav-B), it is administered in a dose of 0.5 mL and repeated only once, after one month. Heplisav-B can also be used in substitution of the above to complete a 3-dose immunization.

Suppose we are giving immunization to immunocompromised individuals or dialysis patients. In that case, we should use either Engerix-B or Recombivax HB at a dose of 40 mcg IM following the three-dose series depicted above. It is particularly important to detect diabetes patients without immunization and administer the vaccine because they have an increased risk of infection with the hepatitis B virus. However, diabetic patients older than 60 years old should only be vaccinated under their physician’s discretion.