Hepatitis B Vaccine : Missed Doses (Adult)

• Hepavax-Gene (recombinant, thiomersal free)

Dosing Schedule

• First dose : as soon as possible
• Second dose : 1-2 months after the first dose
• Third dose : 4-6 months after the first dose
• Suggestion : a series of 3 doses at month 0, 1 and 6.
• Titer testing (not routinely recommended) done 1-2 months after third dose

Missed Doses

• Minimal interval of at least 4 weeks (dose 1 and 2) and at least 8 weeks (dose 2 and 3) and 16 weeks (dose 1 and 3)
• Whenever missed dose occurs, can continue as soon as possible without needing to restart the series
• It is not necessary to restart the series because of an extended interval between doses, no matter how long
• Not much evidence on maximum duration between doses. Only one source states ‘up to 2 years’

Reference:

1. https://www.cdc.gov/hepatitis/hbv/hbvfaq.htm
2. http://www.hepb.org/blog/the-3-shot-hbv-vaccine-do-i-need-to-restart-the-series-if-i-am-off-the-recommended-schedule/
3. http://www.immunize.org/askexperts/experts_hepb.asp
4. https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html