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Recommended doses of recombinant hepatitis B vaccines licensed in the United States for persons aged 18 years and older

Recommended doses of recombinant hepatitis B vaccines licensed in the United States for persons aged 18 years and older
  Age group and associated conditions Volume (mL) Dose HBsAg (mcg) Recommended schedule
Single-antigen vaccines
Recombivax HB
Pediatric/adolescent formulation 18 through 19 years 0.5 5 0, 1, and 6 months
Adult formulation ≥20 years 1 10
Dialysis formulation Adults on hemodialysis and other immunocompromised adults aged ≥20 years 1 40 0, 1, and 6 months
Engerix-B 18 through 19 years 0.5 10 0, 1, and 6 months
≥20 years 1 20
Adults on hemodialysis and other immunocompromised adults aged ≥20 years 2* 40 0, 1, 2, and 6 months
Heplisav-BΔ ≥18 years 0.5 20 0 and 1 months
PreHevbrioΔ ≥18 years 1 10 0, 1, and 6 months
Combination vaccine
Twinrix (combined HepB-HepA vaccine) ≥18 years 1 20

Standard: 0, 1, and 6 months

Accelerated: 0, 7, and 21 to 30 days, and 12 months
This table should be used in conjunction with UpToDate content on hepatitis B virus immunization in adults. Recommended doses for persons <18 years of age can be found in the UpToDate content on hepatitis B vaccines for children.

HBsAg: hepatitis B surface antigen; HepB: hepatitis B; HepA: hepatitis A.

* This is a double dose of the standard formulation of Engerix-B for patients ≥20 years of age (Engerix-B does not have a separate dialysis formulation).

¶ HepB-CpG (sold as Heplisav-B) is a recombinant yeast-derived vaccine that contains 3000 mcg of immunostimulatory phosphorothioate oligodeoxyribonucleotide as an adjuvant.

Δ There are insufficient data to inform vaccine-associated risks with Heplisav-B and PreHevbrio in pregnancy. Thus, providers should vaccinate pregnant persons needing HepB vaccination with Engerix-B, Recombivax HB, or Twinrix. In addition, data are not available to assess the effects of Heplisav-B and PreHevbrio on breastfed infants or on maternal milk production and excretion.

◊ The mammalian-derived recombinant hepatitis B vaccine (trivalent), sold as PreHevbrio, was approved for use in the United States in December 2021.
Data from:
  1. 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.
  2. Schillie S, Harris A, Link-Gelles R, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of a Hepatitis B Vaccine with a Novel Adjuvant. MMWR Morb Mortal Wkly Rep 2018; 67:455.
  3. Weng MK, Doshani M, Khan MA, et al. Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:477.
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