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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-B¶Δ ≥18 years 0.5 20 0 and 1 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; HepA: hepatitis A; HepB: hepatitis B.

* 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 Data are not available to assess the effects of Heplisav-B on breastfed infants or on maternal milk production and excretion.

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.
  4. Sandul AL, Rapposelli K, Nyendak M, et al. Updated recommendation for universal hepatitis B vaccination in adults aged 19–59 years — United States, 2024. MMWR Morb Mortal Wkly Rep. 2024; 73:1106.
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