Hepatitis B Vaccine Brand Names
The currently available hepatitis B vaccines in the United States include Recombivax HB, Engerix-B, Heplisav-B, and PreHevbrio as monovalent vaccines, with Twinrix available as a combination hepatitis A and B vaccine. 1
Monovalent Hepatitis B Vaccines
Recombivax HB - Manufactured using recombinant DNA technology in yeast (Saccharomyces cerevisiae), available for all age groups with varying dosages based on age and immune status 1
Engerix-B - A noninfectious recombinant DNA hepatitis B vaccine containing purified surface antigen of the virus obtained from genetically engineered Saccharomyces cerevisiae cells 2, 3
Heplisav-B - A newer two-dose vaccine approved only for adults ≥18 years, offering the advantage of a shorter vaccination schedule (0 and 1 month) compared to traditional three-dose vaccines 1, 4
PreHevbrio - Recently approved (mentioned in 2022 ACIP recommendations) for adults ≥18 years, administered as a three-dose series at 0,1, and 6 months 1, 5
Combination Vaccine
- Twinrix - A combination hepatitis A and hepatitis B vaccine approved for use in persons aged ≥18 years who are at increased risk for both hepatitis A and B virus infections 1, 5
Key Considerations for Different Populations
Adults (≥18 years)
- Standard dosing for Recombivax HB: 10 μg (1.0 mL) per dose in a 3-dose schedule 1, 5
- Standard dosing for Engerix-B: 20 μg (1.0 mL) per dose in a 3-dose schedule 1, 5
- Standard dosing for Heplisav-B: 20 μg (0.5 mL) per dose in a 2-dose schedule 1, 5
- Standard dosing for PreHevbrio: 10 μg (1.0 mL) per dose in a 3-dose schedule 1, 5
Special Populations
- For hemodialysis patients and immunocompromised adults ≥20 years:
Pregnancy Considerations
- For pregnant women, the CDC recommends using Engerix-B, Recombivax HB, or Twinrix as there is insufficient data on vaccine-associated risks in pregnancy for Heplisav-B and PreHevbrio 1, 5
Clinical Advantages of Different Formulations
Heplisav-B has demonstrated higher seroprotection rates (approximately 90%) compared to Engerix-B (70.5%-90.2%) in clinical trials, potentially offering better protection with fewer doses 1, 4
The two-dose schedule of Heplisav-B may improve adherence to the complete vaccination series compared to three-dose vaccines, potentially increasing overall seroprotection rates by approximately 275,000 per million persons starting vaccination 6
Despite higher per-dose costs, Heplisav-B has been shown to have a lower cost per person seroprotected (approximately 15% lower) compared to Engerix-B due to higher seroprotection rates 6
Interchangeability
If the hepatitis B vaccination schedule is interrupted, the series does not need to be restarted; simply continue where left off 1, 5
Studies have demonstrated that vaccines can be interchangeable, with a three-dose hepatitis B vaccination schedule begun with one vaccine (e.g., Engerix-B) being safely completed with another vaccine (e.g., Euvax-B, though this specific brand may not be available in all regions) 7