Hepatitis B 
Vaccination of Adults
Hepatitis B vaccine has been successfully integrated into the childhood vaccination schedule, contributing to a 96% decline in the incidence of acute hepatitis B in children and adolescents. Currently, approximately 95% of new HBV infections occur among adults, and unvaccinated adults with behavioral risk factors or who are household contacts or sex partners of HBV-infected persons remain at risk.
An
estimated 80%–95% of sexually transmitted diseases (STDs) are diagnosed
in medical settings other than STD clinics. Therefore, primary care and
specialty medical care providers should provide hepatitis B vaccination
whenever indicated or requested as part of regular preventive care.
In primary care and specialty medical settings, including physician’s offices, family planning clinics, community health centers, liver disease clinics, and travel clinics, the Advisory Committee on Immunization Practices (ACIP) recommends that providers implement standing orders to identify adults recommended for hepatitis B vaccination and administer vaccination as part of routine services.
Guidelines and Recommendations
Appendix A: Immunization Management IssuesAppendix B: Postexposure Prophylaxis to Prevent HBV InfectionAppendix C: Identification/Management of HBsAg–Positive PersonsPDF version: (with appendices)
Implementation Guidelines
- Provide information to all adults regarding the benefits of hepatitis B vaccination
- Assess the need for vaccination by obtaining a history that emphasizes risks for sexual or bloodborne transmission of HBV
- Vaccinate all adults who report risk factors for HBV infection
- Vaccinate anyone seeking protection from hepatitis B; identification of a specific risk factor is not required
- Identify, counsel, and vaccinate susceptible household, sex, and needle-sharing contacts of hepatitis B surface antigen (HBsAg)-positive persons
- Assess patients' needs for other recommended vaccines
- Vaccinate all adults receiving services in the following settings:
Immunization Schedules and Dosages
Recommended doses of hepatitis B vaccines (by age group and vaccine type)
Standing Orders
Use of Standing
Orders Programs to Increase Adult Vaccination Rates: Recommendations of
the Advisory Committee on Immunization Practices
MMWR 2000;49(RR-1):15–26
Standing
Orders for Administering Hepatitis B Vaccine to Adults
Vaccine Funding, Billing, and Reimbursement
Coding Guidelines for Vaccine Preventable Hepatitis
Brochure from the American Medical Association that provides CPT and
ICD coding guidelines for hepatitis A and hepatitis B in high-risk populations
Merck Vaccine Reimbursement
Support Center
Service to assist physicians in filing for reimbursement for Merck vaccines
and their administration
Merck Vaccine
Patient Assistance Program
Provides vaccines free of charge to eligible adults, primarily the uninsured
HepClinics
Online guide to free and low-cost hepatitis vaccine clinics
Specific Sites and Tools
Adults Only Vaccination: A Step-by-Step
Guide (2004)
Guide from the Immunization Action Coalition to help integrate immunization services
into healthcare settings new to vaccination
Related Pages
Page last modified: June 16, 2008
Content source:
Division of Viral Hepatitis
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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Excel file link - requires Microsoft Excel™ or
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Link to State/Local government sites