Hepatitis B vaccine (Hep B):

Hepatitis B vaccine (Hep B):

• Hepatitis B vaccine can be routinely given to infants or preadolescents, depending on the provincial/territorial policy. The first dose can be given at 1 month, or at 2 months of age to fit more conveniently with other routine infant immunization visits. The second dose should be administered at least 1 month after the first dose, and the third at least 2 months after the second dose, but again may fit more conveniently into the 4- and 6-month immunization visits. Alternatively, Hep B can be administered as DTaP-IPV-Hib- HepB vaccine in infants, with the first dose at 2 months of age. A two-dose schedule for adolescents is an option.
• For infants born to a mother with acute or chronic hepatitis B (HBsAg-positive), the first dose of Hep B vaccine should be given at birth (with Hepatitis B immune globulin) and repeat doses of vaccine at 1 and 6 months of age. Premature infants of birthweight less than 2,000 grams, born to HB- infected mothers, require four doses of HB vaccine at 0, 1, 2, and 6 months. The last dose should not be given before 6 months of age. Infants of HBsAg- positive mothers also require Hepatitis B immune globulin at birth and follow-up immune status at 9–12 months for HBV antibodies and HBsAg.
• Infants with HBsAg-positive fathers, siblings, or other household contacts require Hepatitis B vaccine at birth, and at 1 month, and 6 months of age.
• Hepatitis B vaccine should also be given to all infants from high-risk groups, such as:
  
  
  • infants where at least one parent has emigrated from a country where Hepatitis B is endemic;
  • infants of mothers positive for Hepatitis C virus;
  • infants of substance-abusing mothers.
• For children in medically high risk groups (e.g. immunocompromising conditions, chronic renal failure, dialysis), see Hepatitis B chapter in the Canadian Immunization Guide for schedules re: timing and number of Hep B vaccine doses and monitoring of HB antibody levels.