HEPATITIS B VACCINE
"B" SMART ABOUT HEPATITIS B
With the introduction of new vaccines and combination vaccines, it is becoming increasingly difficult for health care providers to keep track of minimum dosing intervals. The New Jersey Department of Health and Senior Services (NJDHSS) would like to stress the importance of maintaining appropriate dosing intervals to ensure that children develop and maintain adequate antibody levels and meet the vaccination requirements for school attendance.
There has been confusion regarding the hepatitis B vaccine schedule for children. NJDHSS supports the recommendation of the Centers for Disease Control and Prevention (CDC) to vaccinate children at birth.
The minimum interval between the first and second dose:
Weeks after first dose - 1 month or 4 weeks or 28 days
There are three minimum intervals that must be met for the third dose:
Weeks after first dose - 4 months or 16 weeks or 112 days
Weeks after second dose - 2 months or 8 weeks or 56 days
Weeks after birth - 6 months or 24 weeks or 168 day
There is a four-day grace period for all vaccines.
Please note the following minimum intervals after the birth dose:
Poorer immune responses are seen in infants who complete the vaccination series prior to six months of age.
Please remember that Comvax and Pediarix should not be given to infants under the age of six weeks. The use of Comvax prior to age six weeks can cause the suppression of the immune response to the Hib component in Comvax. The use of Pediarix prior to age 6 weeks can result in suppression of the immune response to the acellular pertussis component of Pediarix.
It is acceptable to give a four-dose schedule of hepatitis B vaccine to infants. The use of this four-dose hepatitis B vaccine schedule is necessary when giving the monovalent hepatitis B vaccine birth dose followed by the use of combination vaccines Comvax or Pediarix. The use of a four-dose regimen does not increase vaccine reactogenicity and results in higher final antibody titers that may correlate with longer duration of detectable antibody.
The federal Vaccine for Children (VFC) program provides up to four doses of hepatitis B vaccine for VFC-eligible children. You may still use monovalent hepatitis B vaccine in a three-dose series.
NJDHSS recommends the use of a customized vaccine scheduler to ensure that all vaccines are administered according to recommended guidelines such as those available through the New Jersey Immunization Information System (NJIIS) or the CDC.