Contraindications and precautions for hepatitis B vaccines

Contraindications

Severe allergic reaction (eg, anaphylaxis) after a previous dose or to a vaccine component (eg, yeast)

Precautions

Infant weighing <2 kg (4.4 pounds)*

Moderate or severe illness with or without fever (ie, illness more severe than upper respiratory infection, otitis media, gastroenteritis)

Hepatitis B vaccine may be given to patients with the following conditions that are incorrectly perceived as contraindications or precautions to hepatitis B vaccine

Pregnancy

Autoimmune disease (eg, systemic lupus erythematosus, rheumatoid arthritis)

Hepatitis B vaccine may be given to patients with the following conditions that are incorrectly perceived as contraindications or precautions to immunization

Mild acute illness with or without fever (eg, upper respiratory infection, otitis media, gastroenteritis)

Mild-to-moderate local reaction (eg, swelling, redness, soreness) after previous dose

Low-grade or moderate fever after previous dose

Current antibacterial therapy (except for oral typhoid vaccine)

Convalescent phase of illness

Recent exposure to infectious disease

History of penicillin allergy, other nonvaccine allergies, relatives with allergies, or receiving allergen extract immunotherapy

History of Guillain-Barré syndrome

HBsAg: hepatitis B surface antigen.
* Hepatitis B vaccination should be deferred for infants weighing <2 kg (4.4 pounds) if the mother is documented to be HBsAg-negative at the time of the infant's birth. Vaccination can begin when the infant is one month old or at hospital discharge. For infants born to mothers who are HBsAg-positive, hepatitis B immune globulin and hepatitis B vaccine should be administered within 12 hours after birth, regardless of weight.

References:

Schillie S, Vellozzi C, Reingold A, et al. Prevention of hepatitis B virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2018; 67:1.
Kroger A, Bahta L, Hunter P. General Best Practice Guidelines for Immunization. Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP). Contraindications and precautions. Available at: www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html. Accessed on February 23, 2022.

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Contraindications and precautions for hepatitis B vaccines