Can the Hepatitis B (Hep B) vaccine be administered to an adult with a sinus infection without fever?

Hepatitis B Vaccine Administration During Sinus Infection Without Fever

Yes, you can and should administer the Hepatitis B vaccine to an adult with a sinus infection without fever. A sinus infection without fever is considered a mild illness and does not require deferral of vaccination. 1

Key Guideline Principle

The ACIP explicitly states that vaccination should only be deferred for persons with moderate or severe acute illness, with or without fever. 1 A sinus infection without fever does not meet this threshold and is classified as a mild illness that should not delay vaccination.

Clinical Decision Algorithm

Proceed with vaccination if:

• The patient has a mild upper respiratory infection (like a sinus infection) without fever 1
• The patient is able to tolerate the visit and provide consent
• No true contraindications exist (history of anaphylaxis to vaccine components or yeast allergy) 1, 2

Defer vaccination only if:

• The patient has moderate to severe acute illness (regardless of fever status) 1
• The patient has a documented history of anaphylaxis to a previous hepatitis B vaccine dose 2
• The patient has known severe allergic reaction to yeast or any vaccine component 1, 2

Important Context on Illness Severity

The distinction between mild and moderate/severe illness is critical. The guideline's intent is to avoid attributing symptoms of the underlying illness to the vaccine, not because mild illnesses increase vaccine risks or decrease vaccine effectiveness. 1

Mild illnesses explicitly do not require deferral, even when accompanied by low-grade fever in some cases. A sinus infection without fever clearly falls into the mild category. 1

Common Pitfall to Avoid

Do not unnecessarily delay vaccination for minor illnesses. This is a frequent barrier to achieving adequate vaccination coverage in adults. 1 The ACIP specifically designed these recommendations to prevent over-cautious deferral that would result in missed vaccination opportunities and incomplete series. 1

Universal Vaccination Context

Remember that ACIP now recommends universal hepatitis B vaccination for all adults aged 19-59 years, regardless of risk factors. 3, 4 For adults ≥60 years, vaccination is recommended for those with any risk factors. 3 You should not require acknowledgment of specific risk factors before vaccinating adults in the recommended age groups. 1, 3