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Vaccination of Adults

Hepatitis B vaccine has been successfully integrated into the childhood vaccination schedule, contributing to a 96% decline in the incidence of acute Hepatitis B in children and adolescents. Currently, approximately 95% of new HBV infections occur among adults, and unvaccinated adults with behavioral risk factors or who are household contacts or sex partners of HBV-infected persons remain at risk.

HPVAn estimated 80%–95% of sexually transmitted diseases (STDs) are diagnosed in medical settings other than STD clinics. Therefore, primary care and specialty medical care providers should provide Hepatitis B vaccination whenever indicated or requested as part of regular preventive care.

In primary care and specialty medical settings, including physician’s offices, family planning clinics, community health centers, liver disease clinics, and travel clinics, the Advisory Committee on Immunization Practices (ACIP) recommends that providers implement standing orders to identify adults recommended for Hepatitis B vaccination and administer vaccination as part of routine services.

 

Guidelines and Recommendations

Hepatitis B Vaccination Recommendations for Adults

MMWR 2006;55(RR-16)
Appendix A: Immunization Management Issues
Appendix B: Postexposure Prophylaxis to Prevent HBV Infection
Appendix C: Identification/Management of HBsAg–Positive Persons

PDF version [PDF - 40 pages]: (with appendices)

 

Implementation Guidelines

To ensure vaccination of persons at risk for HBV infection, health care providers should

 

Immunization Schedules and Dosages

Adult Immunization Schedule

Recommended doses of Hepatitis B vaccines (by age group and vaccine type)

 

Standing Orders

Use of Standing Orders Programs to Increase Adult Vaccination Rates: Recommendations of the Advisory Committee on Immunization Practices
MMWR 2000;49(RR-1):15–26

Standing Orders for Administering Hepatitis B Vaccine to Adults [PDF - 1 page]

 

Vaccine Funding, Billing, and Reimbursement

Coding Guidelines for Vaccine Preventable Hepatitis [PDF - 2 pages]
Brochure from the American Medical Association that provides CPT and ICD coding guidelines for Hepatitis A and Hepatitis B in high-risk populations

Merck Vaccine Reimbursement Support Center
Service to assist physicians in filing for reimbursement for Merck vaccines and their administration

Merck Vaccine Patient Assistance Program
Provides vaccines free of charge to eligible adults, primarily the uninsured

 

Specific Sites and Tools

Adults Only Vaccination: A Step-by-Step Guide (2004)
Guide from the Immunization Action Coalition to help integrate immunization services into health care settings new to vaccination

 

Related Pages

Patient Education Resources

Travelers' Health

Vaccines and Immunizations


 
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