- Other brands that contain hepatitis B vaccine
- (In combination with hepatitis A) Twinrix®
Vaccine type: subunit, recombinant
Schedule and administration
Recombivax HB 10mcg replaces HBvaxPRO 10mcg and is funded for:
- Adolescents aged 11–15 years, to catch-up missed doses of vaccine.
- Adults aged 20 years or older who meet the 'special groups' eligibility criteria
- Household or sexual contacts of a known acute hepatitis B case or hepatitis B carrier
- Individuals who are HIV-positive
- Individuals who are hepatitis C positive
- Following immunosuppression due to steroid or other immunosuppressive therapy longer than 28 days
- Non-consensual sexual intercourse
- Needle stick injury
HBvaxPRO 40mcg is funded for:
- Adults aged 20 years or older who are on renal dialysis or who are liver or kidney transplant patients.
For groups not eligible for funded hepatitis B vaccine but for whom hepatitis B vaccine is recommended, Engerix®-B vaccine is available to purchase for adults from 18 years of age.
Hepatitis B vaccine is recommended and may be funded by an employer for those at occupational risk of being infected with hepatitis B through contact with blood or bodily fluids e.g.:
- Health professionals: dentists, doctors, nurses, midwives, laboratory staff and students in training for these occupations
- Allied healthcare staff who come into contact with bodily fluids and blood - healthcare assistants, care workers in residential and non-residential facilities, morticians and funeral workers, hospital orderlies
- Emergency service personnel
- Members of the armed forces
- Correctional facility staff
- Sex industry workers
- Tattooists and body piercers
In addition to occupational groups, the Engerix®B vaccine is also recommended but not funded for the follow groups who are at risk of infection:
- Adults with severe kidney disease who may require dialysis in the future
- Those expecting to receive a solid organ or bone marrow transplant if they are not already protected against hepatitis B
- People with chronic liver disease or who are at risk of developing chronic liver disease, e.g. people who misuse alcohol
- Recipients of blood products, such as factor VIII
- Migrants from and travellers to hepatitis B endemic countries
- People with developmental disabilities
- Inmates of correctional facilities
- Adults at risk of infection through sexual exposure, including men who have sex with men and individuals being treated for other sexually transmitted diseases.
- Injecting drug users
Recommended schedule: doses spaced at 0, 1 and 2 months after dose 1 (except individuals who are HIV-positive or immunosuppressed)
HIV-positive or Immunosuppressed schedule: 0, 1 month and 6 months (after first dose)
Adolescents aged 11-15 years can complete either a three-dose schedule with child dose of HBvaxPRO 5µg/ml or two-dose schedule with adult dose of Recombivax HB10µg/ml
See Immunisation Handbook for further details on catch-up schedules and doses
Storage and preparation
Store as per cold chain between 2°C to 8°C.
Recombivax HB does not contain preservative. Once the vial has been penetrated the vaccine should be used promptly.
The primary vaccination schedule for Recombivax HB consists of 3 doses by intramuscular injections (unless the 11–15 year schedule is being followed).
Recombivax HB can be administered concurrently with other vaccines, including all the National Immunisation Schedule vaccines. Separate syringes and different injection sites should be used.
Generally a serology result of ≥10 IU/L (or ≥20 IU/L for high risk individuals, depending on laboratory used) is considered immunity to hepatitis B. Vaccinated individuals who have laboratory confirmation of anti-HBs ≥10 IU/L are considered to have lifetime immunity to hepatitis B even if antibody levels wane to undetectable levels in subsequent serology. This is because an anamnestic immune response will be protective against future hepatitis B exposure.
Refer to the current Immunisation Handbook for information on post-vaccination serology testing and management of non-responders. Non-responders require case-by-case consideration.
Recombivax HB should not be given to:
- Anyone with severe allergy (anaphylaxis) to a previous dose of this vaccine or other hepatitis B containing vaccine, or a component of the vaccine
- Administration of hepatitis B vaccine should be postponed in individuals suffering from a fever over 38°C. The presence of a minor infection is not a reason to delay immunisation.
Specialist advice should be sought for the following groups:
Those with bleeding disorders, such as haemophilia. The vaccine should be administered in accordance with the haematologist’s instructions. It may, in this situation only, be given subcutaneously. An increased incidence of local reactions including subcutaneous nodules has been observed with this method.
It is safe to give during pregnancy if the woman is non-immune to hepatitis B and has had sexual or household contact with a hepatitis B infected person. Recombivax HB can safely be given when breastfeeding.
The response to Recombivax HB varies with age. After a course of three vaccine doses 99% of adolescents 11-19 years of age, 98% of young adults 20-29 years of age, 94% of adults 30-39 years of age, and 89% of adults > 40 years of age were protected from hepatitis B.
Immune memory from recombinant hepatitis B vaccines against clinical disease and chronic hepatitis B infection remains for at least 15-20 years when given to health individuals fully immunised as infants. Cellular immunity appears to remain even when antibody levels decline below detectable levels.
A study of recombinant hepatitis B vaccine recipients 15-16 years earlier, including several whose antibody levels were <10 mIU/mL, demonstrated an anamnestic antibody response to a booster/challenge dose of hepatitis B vaccine. Routine measurement of hepatitis B antibodies post-vaccination is not recommended. The exception would be when the vaccinee may be at increased risk and evidence of seroconversion is required. Serology should be done four weeks after the third vaccine dose.