Hepatitis B Vaccination of Adults
The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis B (HepB) vaccination among all adults aged 19–59 years and adults > 60 years with risk factors for hepatitis B or without identified risk factors but seeking protection.
Current Issues in Immunization Webinar: Update on ACIP Recommendations for Hepatitis B Vaccination
Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022
MMWR / April 1, 2022 / 71(13):477-483.
MMWR Recommendations and Reports / January 12, 2018 / 67(1):1–31.
Adults recommended to receive HepB vaccine:
The Advisory Committee on Immunization Practices (ACIP) recommends that the following people should receive hepatitis B vaccination:
- All infants
- Unvaccinated children aged <19 years
- Adults aged 19 through 59 years
- Adults aged 60 years and older with risk factors for hepatitis B
The following groups may receive hepatitis B vaccination:
- Adults aged 60 years and older without known risk factors for hepatitis B
Risk factors for hepatitis B
- Persons at risk for infection by sexual exposure
- Sex partners of persons who test positive for hepatitis B surface antigen (HBsAg)
- Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than one sex partner during the previous 6 months)
- Persons seeking evaluation or treatment for a sexually transmitted infection
- Men who have sex with men
- Persons at risk for infection by percutaneous or mucosal exposure to blood
- Persons with current or recent injection use
- Household contacts of persons who test positive for HBsAg
- Residents and staff of facilities for persons with developmental disabilities
- Health care and public safety personnel with reasonably anticipated risk for exposure to blood or blood-contaminated body fluids
- Persons on maintenance dialysis, including in-center or home hemodialysis and peritoneal dialysis, and persons who are predialysis
- Persons with diabetes at the discretion of the treating clinician
- International travelers to countries with high or intermediate levels of endemic hepatitis B virus (HBV) infection (HBsAg prevalence of ≥2%)
- Persons with hepatitis C virus infection
- Persons with chronic liver disease (including, but not limited to, persons with cirrhosis, fatty liver disease, alcoholic liver disease, autoimmune hepatitis, or an alanine aminotransferase [ALT] or aspartate aminotransferase [AST] level greater than twice the upper limit of normal)
- Persons with HIV infection
- Incarcerated persons
NAIIS Call to Action
At least 3 out of every 4 adults are missing one or more routinely recommended vaccines. Providers can take actions to improve vaccination of adults. Learn more about the National Adult and Influenza Immunization Summit (NAIIS) Call to Action:
To ensure vaccination of persons at risk for HBV infection, health care providers should:
- Offer HepB vaccination to all adults aged 19–59 years who have not previously completed vaccination, as well as adults > 60 years with risk factors for hepatitis B or without identified risk factors but seeking protection.
- Implement standing orders to administer HepB vaccine as part of routine services to adults who have not completed the vaccine series.
- Offer HepB vaccination, when feasible, in outreach and other settings in which services are provided to persons at risk for HBV infection (e.g., syringe services programs, HIV testing sites, HIV prevention programs, homeless shelters).
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