Hepatitis B - Vaccination of Adults

Hepatitis B virus (HBV) is transmitted via blood or sexual contact. People with chronic HBV infection are at increased risk for cirrhosis and liver cancer and require medical care. ACIP recommends vaccination of adults at risk for HBV infection, including universal vaccination of adults in settings in which a high proportion have risk factors for HBV infection and vaccination of adults requesting protection from HBV without acknowledgment of a specific risk factor.

Guidelines and Recommendations

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization PracticesMMWR Recommendations and Reports / January 12, 2018 / 67(1);1–31

Hepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice From the American College of Physicians and CDC

Recommendations of the Advisory Committee on Immunization Practices for Use of a Hepatitis B Vaccine with a Novel Adjuvant

Implementation Guidelines

To ensure vaccination of persons at risk for HBV infection, health care providers should

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

Adult Immunization Schedule

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[PDF – 1 page]

Vaccine Funding, Billing, and Reimbursement

Coding Guidelines for Vaccine Preventable Hepatitis[PDF – 2 pages]
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 Patient Assistance Program
Provides vaccines free of charge to eligible adults, primarily the uninsured

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 health care settings new to vaccination

Travelers’ Health

Vaccines and Immunizations