Candidates for Hepatitis A Vaccination
Routine Vaccination
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Children living in areas with high incidence rates of hepatitis A. |
High-Risk Populations
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Travelers to developing countries with high rates of hepatitis A, including Mexico |
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Men who have sex with men |
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Users of illegal drugs |
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People who work with hepatitis A virus in research settings |
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People who work with infected nonhuman primates |
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Recipients of clotting factor concentrates |
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People with chronic liver disease (because of risk of fulminant hepatitis A) |
Postexposure Prophylaxis
Immune globulin (IG) can provide temporary immunity to hepatitis A when given within 2 weeks of exposure to the hepatitis A virus. The dose is 0.02 mL/kg injected into the gluteal muscle in adults or the anterolateral thigh muscle in children under 2 years. Concurrent hepatitis A vaccination may also be appropriate in people 2 years and older. IG protects against the hepatitis A virus for 3 to 5 months, depending on dosage.
Candidates for Hepatitis B Vaccination
Routine Vaccination
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All infants, children, and adolescents |
High-Risk Populations
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People with multiple sex partners and those who have been recently diagnosed with a sexually transmitted disease |
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Sex partners and household contacts of HBV carriers |
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Men who have sex with men |
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Household contacts of adoptees from countries with high rates of hepatitis B |
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Injection drug users |
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Travelers to countries with high rates of hepatitis B (staying longer than 6 months) |
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People with occupational exposure to blood |
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Clients and staff in institutions for the developmentally disabled |
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Patients with chronic kidney failure (including those on chronic hemodialysis) |
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Patients receiving clotting factor concentrates |
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Inmates of long-term correctional facilities |
Postexposure Prophylaxis
Prophylactic treatment for exposure to hepatitis B virus involves either hepatitis B immune globulin (HBIG), hepatitis B vaccine, or a combination of both. The HBIG dose equals 0.06 mL/kg. Efficacy ranges from 70 to 95 percent for different types of exposure.
| Exposure |
Treatment |
| Perinatal |
1 dose of HBIG given with the first hepatitis B vaccine dose. |
| Percutaneous or permucosal |
HBIG and vaccination depending on vaccination and exposure status. |
| Sexual |
HBIG with or without vaccination for exposure to acute hepatitis B; vaccination alone for chronic exposure. |
| Household contact |
HBIG with vaccination for acute hepatitis B in infants under age 12 months; vaccination alone for chronic. |
Combination Vaccine
There are combination vaccines available that combine vaccinations for both hepatitis A and hepatitis B in one injection. It protects individuals 18 years of age or older against diseases caused by hepatitis A and hepatitis B viruses. The vaccine is recommended for travelers whose occupation or behavior puts them at high risk for exposure to hepatitis B virus, or who are visiting countries with a high or intermediate rate of both hepatitis viruses, as defined by the Centers for Disease Control and Prevention. |
