CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Immunizations - travel vaccinations - Management
View full scenario
Definition
- Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV). Acute infection may occasionally lead to fulminant hepatic necrosis, which is often fatal.
When is hepatitis B vaccine indicated?
- Travellers to areas of high or intermediate prevalence who place themselves at risk when abroad. Behaviours that place them at risk include unsafe sexual activity, injecting drug use, undertaking relief aid work, or participating in contact sports.
- Travellers who plan to remain in areas of high or intermediate prevalence for lengthy periods.
- Individuals who are travelling to visit friends or relatives with chronic hepatitis B infection.
- Families adopting children from countries with a high or intermediate prevalence of hepatitis B.
- People who may require medical care while travelling to areas of high- or moderate-endemicity.
In depth
What types of hepatitis B vaccines are available?
- There are several inactivated hepatitis B vaccines available: Engerix B®, Fendrix®, HBvaxPRO®, and Twinrix® (combined hepatitis A and B).
In depth
What schedule is used for hepatitis B vaccination?
Table 1. Schedule for Hepatitis B vaccination.
Vaccine | Schedule | Age range |
|---|
Engerix B® | 3 doses: 0, 1, and 6 months | Neonates to adults. |
HBVaxPRO® 5 micrograms | 3 doses: 0, 1, and 6 months | from birth to 15 years. |
HBVaxPRO® 10 micrograms | 3 doses: 0, 1, and 6 months | 16 years and older. |
Health care workers are advised to receive a booster dose 5 years after the primary course (according to Department of Health policy). |
In depth
Can I use a rapid schedule for hepatitis B vaccine?
Table 1. Rapid schedule for hepatitis B vaccine.
Vaccine | Rapid schedule | Age range |
|---|
Engerix B® | 3 doses: 0, 1, and 2 months*† | Neonates to adults. |
3 doses: 0, 7, and 21 days*† | 18 years and older.‡ |
HBVaxPro® 5 micrograms | 3 doses: 0, 1, and 2 months* | From birth to 15 years. |
HBVaxPro® 10 micrograms | 3 doses: 0, 1, and 2 months*† | 16 years and older. |
* Give fourth dose after 12 months. † Health care workers are advised to receive a reinforcing dose 5 years after the primary course (according to Department of Health policy). ‡ Although not licensed, this schedule maybe used in those aged 16–18 where it is important to provide rapid protection. |
In depth
What are the adverse effects of hepatitis B vaccine?
- The most common adverse reactions are soreness and redness at the injection site. Serious adverse effects are very rare.
In depth
Prescriptions
Hepatitis B vaccine - children
Age from 1 month to 15 years 11 months
Hepatitis B vaccine (HBvaxPRO)
HBvaxPRO 5micrograms/0.5ml suspension for injection vials
Give 0.5 ml by intramuscular injection. Give a second dose one month later, then give a third dose 6 months after the first dose.
Supply 1 0.5ml vial.
Age from 1 year to 15 years 11 months
Hepatitis B vaccine (Engerix B paed)
Engerix B 10micrograms/0.5ml suspension for injection pre-filled syringes
Give 0.5 ml by intramuscular injection. Give a second dose one month later, then give a third dose 6 months after the first dose.
Supply 1 0.5ml prefilled syringe.
Hepatitis B vaccine - adults
Age from 16 years onwards
Hepatitis B vaccine (Engerix B)
Engerix B 20micrograms/1ml suspension for injection pre-filled syringes
Give 1 ml by intramuscular injection. Give a second dose one month later, then give a third dose 6 months after the first dose.
Supply 1 1ml prefilled syringe.
Hepatitis B vaccine (HBvaxPRO)
HBvaxPRO 10micrograms/1ml suspension for injection vials
Give 1 ml by intramuscular injection. Give a second dose one month later, then give a third dose 6 months after the first dose.
Supply 1 1 ml vial.
Hepatitis B vaccine: rapid schedule - children
Age from 1 month to 15 years 11 months
Hepatitis B vaccine (HBvaxPRO): 3 month course
HBvaxPRO 5micrograms/0.5ml suspension for injection vials
Give 0.5ml by intramuscular injection. For primary immunization, give three doses at intervals of 1 month between doses.
Supply 1 0.5ml vial.
Age from 1 year to 15 years 11 months
Hepatitis B vaccine (Engerix B paed): 3 month course
Engerix B 10micrograms/0.5ml suspension for injection pre-filled syringes
Give 0.5ml by deep intramuscular injection. For primary immunization, give three doses at intervals of 1 month between doses.
Supply 1 0.5ml prefilled syringe.
Hepatitis A and hepatitis B combined vaccine
Age from 1 year to 15 years 11 months
Hepatitis A + hepatitis B vaccine (Twinrix Paed)
Twinrix Paediatric suspension for injection 0.5ml pre-filled syringes
Give 0.5 ml by intramuscular injection. Give a second dose one month later, then give a third dose 6 months after the first dose.
Supply 1 0.5ml prefilled syringe.
Hepatitis A + hepatitis B vaccine (Ambirix)
Ambirix vaccine suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection.
Supply 1 1ml prefilled syringe.
Age from 16 years onwards
Hepatitis A + hepatitis B vaccine (Twinrix Adult)
Twinrix Adult suspension for injection 1ml pre-filled syringes
Give 1 ml by intramuscular injection. Give a second dose one month later, then give a third dose 6 months after the first dose.
Supply 1 1ml prefilled syringe.
Hepatitis A + hepatitis B combined: rapid schedule
Age from 1 year to 15 years 11 months
Hepatitis A + hepatitis B vaccine (Ambirix)
Ambirix vaccine suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection.
Supply 1 1ml prefilled syringe.
Age from 16 years onwards
Hepatitis A + hepatitis B vaccine: rapid schedule
Twinrix Adult suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection. For rapid primary immunization, give 3 doses on days 0, 7, and 21.
Supply 1 1ml prefilled syringe.
© NHS Institute for Innovation and Improvement