From the Guidelines
The most effective rapid hepatitis B vaccination schedule is the 2-dose series of Heplisav-B, administered at 0 and 1 month, as recommended by the Advisory Committee on Immunization Practices (ACIP) in 2022 1. This schedule is ideal for individuals who need quick protection against hepatitis B, such as those with high-risk occupations or travelers to endemic areas.
- The Heplisav-B vaccine is administered in a 2-dose series, with each dose containing 20 μg of hepatitis B surface antigen.
- The doses are given 1 month apart, providing rapid protection against hepatitis B infection.
- This schedule is recommended for adults aged 18 years and older, and is particularly useful for those who require quick protection due to occupational or travel-related risks.
- It is essential to note that the safety and effectiveness of Heplisav-B have not been established in adults on hemodialysis, and alternative vaccines such as Engerix-B or Recombivax HB may be recommended for these individuals 1.
- Additionally, the ACIP recommends that pregnant individuals needing HepB vaccination should be vaccinated with Engerix-B, Recombivax HB, or Twinrix, as data on Heplisav-B are currently insufficient to inform vaccine-associated risks in pregnancy 1.
From the Research
Rapid Hepatitis B Vaccination Schedules
- Accelerated hepatitis B vaccination schedules have been shown to result in higher proportions of healthy vaccinees reaching anti-HBs antibody levels >or=10 IU/l more rapidly 2.
- A super-accelerated schedule (0.7.21.360 days) can provide rapid seroconversion and almost immediate protection in the short term, but a fourth dose at month 12 is still required for long-term protection 2.
- A shortened schedule (0.1.4 months) might be an alternative worth considering compared with the standard 0.1.6, as it convenes to internationally accepted minimum dose intervals and offers earlier protection 2.
Comparison of Accelerated and Standard Schedules
- Accelerated schedules resulted in higher proportions of healthy vaccines more rapidly reaching anti-hepatitis B antibody levels >10 IU/L initially, but similar seroprotection rates after 6 months 3.
- A three-week hepatitis B vaccination schedule (on days 0,10, and 21) provides immediate and protective immunity, with 58.9% of vaccinees reaching seroprotective levels of Anti-HBs on day 30 4.
- Accelerated schedules produced anti-hepatitis B levels higher than the standard schedule for the first month after the initial vaccine dose, but were significantly lower than the standard schedule after 6 months, except for an accelerated schedule that called for a fourth booster injection 12 months after the initial dose 3.
Long-Term Effectiveness
- The long-term effectiveness of an accelerated hepatitis B vaccination schedule in drug users has been demonstrated, with significantly lower HBV infection rates compared to a standard schedule 5.
- However, additional studies on the long-term protection and effectiveness of the primary doses of accelerated schedules are necessary 3.
- A fourth dose at month 12 is still required for long-term protection, even with accelerated schedules 2, 3.