From the Guidelines
The recommended dosing schedule for Engerix-B (Hepatitis B vaccine) 20mcg in adults is a three-dose series administered at 0,1, and 6 months. This schedule is based on the most recent guidelines from the Advisory Committee on Immunization Practices (ACIP) in 2022, as reported in the Morbidity and Mortality Weekly Report 1. The Engerix-B vaccine is administered as an intramuscular injection in the deltoid muscle, with each dose containing 20mcg of hepatitis B surface antigen.
Key points to consider when administering the Engerix-B vaccine include:
- The vaccine should be stored in the refrigerator between 2-8°C (36-46°F) and should never be frozen.
- For optimal protection, it's essential to complete the entire series according to schedule.
- If the series is interrupted, it can be resumed without restarting the entire series, as long as the minimum intervals between doses are respected 1.
- The vaccine works by stimulating the immune system to produce antibodies against the hepatitis B virus, providing long-term protection against hepatitis B infection.
- Most healthy adults who complete the series develop protective antibody levels, with protection lasting for at least 20 years in most individuals.
It's also important to note that the ACIP recommends that adults aged 19–59 years and adults aged ≥60 years with risk factors for hepatitis B should receive HepB vaccines, and that adults aged ≥60 years without known risk factors for hepatitis B may receive HepB vaccines 1. However, the dosing schedule remains the same for all adult populations, unless specific conditions such as hemodialysis or immunocompromised status require a different schedule, as outlined in the guidelines 1.
From the FDA Drug Label
The usual immunization regimen (see Table 1) consists of 3 doses of vaccine given according to the following schedule: first dose: at elected date; second dose: 1 month later; third dose: 6 months after first dose.
Table 1. Recommended Dosage and Administration Schedules Group Dose Schedules ... Adults (>19 years) 20 mcg/1.0 mL 0,1,6 months
The recommended dosing schedule for the Engerix-B (Hepatitis B vaccine) 20mcg vaccine in adults is 3 doses given at the following schedule:
- First dose: at the elected date
- Second dose: 1 month later
- Third dose: 6 months after the first dose 2.
From the Research
Recommended Dosing Schedule for Engerix-B (Hepatitis B vaccine) 20mcg in Adults
The recommended dosing schedule for Engerix-B (Hepatitis B vaccine) 20mcg in adults is as follows:
- A 0-, 1-, 6-month schedule is commonly used, with seroprotection rates of 85-100% seen approximately 1 month after the final dose of vaccine 3.
- Alternative schedules, such as a 0-, 1-, 2-, 12-month schedule, or accelerated schedules, have also been associated with high rates of seroprotection 3.
- For adults, a 0-, 12-, 24-month schedule has been shown to be highly immunogenic, with >98% of recipients achieving anti-HBs concentrations ≥10 mIU/mL one month after the third dose 4.
Special Considerations
- For patients undergoing hemodialysis, a 0-, 1-, 2-, and 6-month schedule with 40 μg/dose has been shown to achieve a seroconversion rate of 79% one month after the last dose 5.
- Revaccination of non-responders with an additional 3-dose series has been shown to substantially increase the pool of protected patients 6.
Immunogenicity and Protective Efficacy
- Engerix-B has excellent immunogenicity in healthy adults, with seroprotection rates of 85-100% seen approximately 1 month after the final dose of vaccine 3.
- The vaccine has also demonstrated good protective efficacy in a number of high-risk groups, including healthcare workers and patients with conditions associated with impaired immune function 3.