Hepatitis B Vaccination for a 23-Year-Old
A 23-year-old adult needs a complete 3-dose series of hepatitis B vaccine if they have not been previously vaccinated, with doses administered at 0,1, and 6 months. 1, 2
Standard Vaccination Schedule
The Advisory Committee on Immunization Practices (ACIP) recommends the following hepatitis B vaccination schedules for adults:
- Standard 3-dose schedule: 0,1, and 6 months for most hepatitis B vaccines 2
- 2-dose schedule: Only available with Heplisav-B vaccine (doses at 0 and 1 month) for adults 18 years and older 1
Available Vaccine Options for a 23-Year-Old:
| Vaccine | Dosing Schedule | Dose |
|---|---|---|
| Recombivax HB | 3 doses at 0,1, and 6 months | 10 μg (1.0 mL) |
| Engerix-B | 3 doses at 0,1, and 6 months | 20 μg (1.0 mL) |
| Heplisav-B | 2 doses at 0 and 1 month | 20 μg (0.5 mL) |
| PreHevbrio | 3 doses at 0,1, and 6 months | 10 μg (1.0 mL) |
| Twinrix (HepA-HepB) | 3 doses at 0,1, and 6 months | 20 μg HepB component (1.0 mL) |
Important Considerations
Completion of the Series
- If the vaccination series is interrupted, it does not need to be restarted 1
- If delayed after the first dose, the second dose should be administered as soon as possible
- The final dose of a 3-dose series must be administered at least 8 weeks after the second dose and at least 16 weeks after the first dose 1
Minimum Intervals
- Minimum interval between first and second doses: 4 weeks
- Minimum interval between second and third doses: 8 weeks
- Minimum interval between first and third doses: 16 weeks 1, 2
Vaccine Efficacy
- Completing the full series is crucial for establishing long-term immunity 2
- More than 90% of healthy adults under 40 years develop protective antibody response after the third dose 2
- The third dose acts as a booster and confers optimal protection 1
Special Situations
Previously Started Series
If the 23-year-old has already started the hepatitis B vaccine series but didn't complete it:
- Continue with the remaining doses following the minimum interval guidelines
- No need to restart the series regardless of time elapsed between doses 1
Alternative Schedules
- An accelerated schedule (0,1,2,12 months) can be used when more rapid protection is needed 3
- Longer intervals between the second and third doses (4-12 months) may result in higher final antibody titers 1
Universal Recommendation
In 2022, ACIP updated recommendations to include universal hepatitis B vaccination for all adults aged 19-59 years, removing the need for risk factor screening 1. This makes the 23-year-old eligible for vaccination regardless of risk factors.
Bottom Line
A 23-year-old needs either a complete 3-dose series (most vaccines) or a 2-dose series (Heplisav-B only) of hepatitis B vaccine. The choice of vaccine may depend on factors such as availability, cost, and the need for rapid protection.