Hepatitis B Immunization Protocol For Ohio Pharmacists.pdf

Unvaccinated persons age 7 through 18 should complete a series of Recombivax HB or Engerix-B. Hepatitis B vaccination is universally recommended for all adults aged 19-59 years. Adults aged 60 years or older with risk factors for hepatitis B include persons at risk for infection by sexual exposure, such as men who have sex with men, and persons who are sexually active and not in a long-term, mutually monogamous relationship. Others at risk include current or recent injection drug users, household contacts of HBsAg-positive persons, and health care personnel and others at occupational risk of infection through exposure to blood or blood-contaminated body fluid.

A history of severe allergic reactions after a previous dose of hepatitis B vaccine or to a hepatitis B vaccine component is a contraindication. Moderate or severe acute illness with or without fever is also a contraindication. Pregnancy is not a contraindication to vaccination, but providers should vaccinate pregnant persons needing HepB vaccination with Engerix-B, Recombivax HB, or Twinrix.

Common side effects and adverse reactions include injection site reactions, mild to moderate fever, fatigue, weakness, headache, and malaise. Anaphylaxis and symptoms of immediate hypersensitivity reactions have been reported within the first few hours after vaccination. An apparent hypersensitivity syndrome of delayed onset has been reported days to weeks after vaccination, including arthralgia/arthritis, fever, and dermatologic reactions.

The standard schedule for Hep B Vaccine is 3 doses at 0, 1, and 6 months for children and adolescents aged 7-19 years, and 3 doses at 0, 1, and 6 months for adults aged >20 years. Adults on hemodialysis and other immunocompromised adults aged >20 years should receive 3 doses at 0, 1, and 6 months. Alternative schedules include a 2-dose schedule for unvaccinated adolescents aged 11-15 years, and a 4-dose schedule for adults on hemodialysis and other immunocompromised adults aged >20 years.

A prescription is required for patients who are seven years of age or older but not more than 13 years of age. The patient or legal guardian must sign a consent form before the vaccination is administered. The patient or legal guardian should be provided with a copy of the most current federal Vaccine Information Statement (VIS) for hepatitis B vaccine. The vaccine should be injected intramuscularly into the thickest point of a relaxed deltoid muscle.