AdultPediatricDosage Forms & Strengths IM suspension, 3-antigen 10mcg/mL (PreHevbrio) IM suspension, single-antigen (adult formulation) 10mcg/mL (Recombivax HB) 20mcg/mL (Engerix B) 40mcg/mL (Recombivax HB [dialysis formulation]) IM solution, single-antigen 20mcg HBsAg and 3000mcg of CpG 1018 adjuvant per 0.5mL (Heplisav-B) Hepatitis B Immunization 3-dose series Engerix B: 1 mL (20 mcg) IM at 0, 1, and 6 months Recombivax HB: 1 mL (10 mcg) IM at 0, 1, and 6 months PreHevbrio: 1 mL IM at 0, 1, and 6 months Heplisav-B: Can be used as a substitute in a 3-dose series with a different hepatitis B vaccine 2-dose series Heplisav-B (aged ≥18 years): 0.5 mL IM at 0 and 1 month Adults with diabetes mellitus CDC ACIP guidelines recommends immunization with hepatitis B vaccine for all unvaccinated adults with diabetes mellitus through age 59 years Persons with diabetes are at increased risk of hepatitis B infection Vaccinate diabetics aged ≥60 yr at the discretion of the treating clinician, based on increased need for assisted blood glucose monitoring in long-term care facilities, likelihood of acquiring hepatitis B infection, its complications or chronic sequelae, and likelihood of immune response to vaccination Vaccination for older unvaccinated diabetic patients may be done at the physician's discretion MMWR Dec 23, 2011/Vol 60(50);1709-11 Dosage Modifications Adults receiving dialysis or other immunocompromising conditions Engerix B or Recombivax HB Primary immunization consists of a series of 4 doses (40 mcg) at 0, 1, 2, and 6 months Antibody response is lower in patients on hemodialysis compare with healthy persons and protection may persist only as long as antibody levels remain above 10 mIU/mL Assess need for booster doses by annual antibody testing Administer 2-mL booster dose for antibody levels <10 mIU/mL Dosing Considerations Routine immunization against hepatitis B; also protects against hepatitis D which always occurs in the presence of hepatitis B Single-antigen vaccines: Engerix B, Heplisav-B (adjuvanted), Recombivax HB 3-antigen vaccine: PreHevbrio Targeted groups that should receive HepB vaccination series include Sexually active persons who are not in a long-term, mutually monogamous relationship persons seeking evaluation or treatment for a sexually transmitted disease (STD); current or recent injection-drug users; and men who have sex with men Health-care personnel and public-safety workers who are potentially exposed to blood or other infectious body fluids Persons with diabetes, HIV infection, or chronic liver disease Persons with end-stage renal disease, including patients receiving hemodialysis Household contacts and sex partners of hepatitis B surface antigen-positive persons; clients and staff members of institutions for persons with developmental disabilities; and international travelers to countries with high or intermediate prevalence of chronic HBV infection All adults in the following settings: STD treatment facilities; HIV testing and treatment facilities; facilities providing drug-abuse treatment and prevention services; health-care settings targeting services to injection-drug users or men who have sex with men; correctional facilities; end-stage renal disease programs and facilities for chronic hemodialysis patients; and institutions and nonresidential daycare facilities for persons with developmental disabilities Pregnant women who are at risk for hepatitis B virus infection during pregnancy (eg, >1 sex partner during the previous 6 months, been evaluated or treated for a sexually transmitted infection, recent or current injection drug use, or had an HBsAg-positive sex partner) International travelers to regions with high or intermediate levels of endemic hepatitis B virus infection should receive a HepB series Additional Information Current vaccination schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.htmlDosage Forms & Strengths IM suspension (pediatric/adolescent formulations) 5mcg/0.5mL (Recombivax HB) 10mcg/0.5mL (Engerix B) Hepatitis B Immunization Primary immunization First dose Medically stable infants weighing ≥2,000 grams born to HBsAg-negative mothers: 0.5 ML IM within 24h of birth Preterm infants weighing <2,000 g born to HBsAg-negative mothers: 0.5 mL IM 1 month after birth or at hospital discharge Infants born to HBsAg-positive mothers: 0.5 mL IM within 12 hr of birth PLUS hepatitis B immune globulin (HBIG); test for HBsAg and antibody to HBsAg (anti-HBs) 1-2 months after completion of hepatitis B vaccination series, at age 9 through 18 months Mother's HBsAg status unknown: 0.5 mL IM within 12 hr of birth PLUS give HBIG; if newborn wt <2 kg, determine mother's HBsAg status as soon as possible and, if she is HBsAg-positive, also administer HBIG for infants weighing 2 kg or more (no later than age 1 week) Second dose Administered at age 1-2 months Monovalent HepB vaccine should be used for doses administered before age 6 weeks Infants who did not receive a birth dose should receive 3 doses of a HepB-containing vaccine on a schedule of 0, 1 to 2 months, and 6 months starting as soon as feasible Minimum interval between dose 1 and dose 2 is 4 weeks, and between dose 2 and 3 is 8 weeks Final (3rd or 4th) dose Administered no earlier than age 24 weeks, and at least 16 weeks after the first dose A total of 4 doses of HepB vaccine is recommended when a combination vaccine containing HepB is administered after the birth dose Catch-up schedule Unvaccinated children should complete a 3-dose series Children aged 11-15 years: 2-dose series (doses separated by at least 4 months) of adult formulation Recombivax HB is licensed for use in children aged 11 through 15 years Interaction CheckerEnter a drug name and hepatitis b vaccineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (1)belimumabbelimumab decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Contraindicated. Do not administer live vaccines 30 days before or concurrently with belimumab.Serious - Use Alternative (39)adalimumabadalimumab decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.alefaceptalefacept decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.anakinraanakinra decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.antithymocyte globulin equineantithymocyte globulin equine decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.antithymocyte globulin rabbitantithymocyte globulin rabbit decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.azathioprineazathioprine decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.basiliximabbasiliximab decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.budesonidebudesonide decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.canakinumabcanakinumab decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.cortisonecortisone decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.deflazacortdeflazacort decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.dexamethasonedexamethasone decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.elivaldogene autotemcelelivaldogene autotemcel, hepatitis b vaccine. Either decreases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: The safety and effectiveness of vaccination during or following elivaldogene autotemcel treatment have not been studied. Vaccination is not recommended during the 6 weeks preceding myeloablative conditioning, and until hematological recovery following elivaldogene autotemcel treatment. Where feasible, administer childhood vaccinations before myeloablative conditioning. .etanerceptetanercept decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.everolimuseverolimus decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.fludrocortisonefludrocortisone decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.glatiramerglatiramer decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.golimumabgolimumab decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.hydrocortisonehydrocortisone decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.hydroxychloroquine sulfatehydroxychloroquine sulfate decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.infliximabinfliximab decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.leflunomideleflunomide decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.methylprednisolonemethylprednisolone decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.muromonab CD3muromonab CD3 decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.mycophenolatemycophenolate decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.ocrelizumabocrelizumab decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Vaccination with live-attenuated or live vaccines is not recommended during ocrelizumab treatment and until B-cell repletion.ofatumumab SCofatumumab SC decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Administer all immunizations according to immunization guidelines at least 2 weeks before initiating ofatumumab SC for inactivated vaccines, and whenever possible.prednisoloneprednisolone decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.prednisoneprednisone decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.rilonaceptrilonacept decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.secukinumabsecukinumab decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Prior to initiating secukinumab, complete all age appropriate immunizations; non-live vaccinations received during treatment with secukinumab may not elicit an immune response sufficient to prevent disease.siponimodsiponimod decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Pause vaccinations beginning 1 week before initiating siponimod and for 4 weeks after stopping treatment. Coadministration with live attenuated vaccines may increase infection risk.sirolimussirolimus decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.tacrolimustacrolimus decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.temsirolimustemsirolimus decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.teplizumabteplizumab decreases effects of hepatitis b vaccine by Other (see comment). Avoid or Use Alternate Drug. Comment: Administer all age-appropriate vaccinations before starting teplizumab. Inactivated or mRNA vaccines are not recommended within 2 weeks before teplizumab treatment, during treatment, or 6 weeks after completion of treatment.tocilizumabtocilizumab decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.triamcinolone acetonide injectable suspensiontriamcinolone acetonide injectable suspension decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.ustekinumabustekinumab decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Contraindicated. Immunosuppressants also increase risk of infection with concomitant live vaccines.Monitor Closely (20)cyclosporinecyclosporine decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. If possible, complete all age-appropriate vaccinations at least 2 weeks before initiating immunosuppressant therapy. Patients vaccinated <14 days before starting immunosuppressive therapy or during immunosuppressive therapy should be revaccinated at least 3 months after therapy is discontinued if immune competence has been restored. Longer waiting periods may be required for drugs that maintain their immunosuppressive effects for more than 3 months after discontinuation (eg, ocrelizumab). .delandistrogene moxeparvovecdelandistrogene moxeparvovec, hepatitis b vaccine. Other (see comment). Use Caution/Monitor. Comment: Consider patient vaccination status before initiating corticosteroid regimen required before delandistrogene moxeparvovec administration. If possible, ensure patients are current with all immunizations according to immunization guidelines. Complete vaccinations at least 4 weeks before starting corticosteroid regimen. High-dose or long-term corticosteroids may decrease immungenicity of vaccines.dengue vaccinedengue vaccine, hepatitis b vaccine. unspecified interaction mechanism. Use Caution/Monitor. Data are not available to establish safety and immunogenicity of coadministration of dengue vaccine with recommended adolescent vaccines.ibrutinibibrutinib decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Coadministration with immunosuppressant therapy reduced efficacy of the