Hepatitis B Immunisation

Hepatitis B Immunisation- HBVaxPro  

Indication Immunisation against hepatitis B infection in all patients starting haemodialysis. 
Dosage and administration 40 micrograms at 0, 1 and 6 months by IM injection

Patients should be regarded as a ‘responder’ if anti HBs antibody titre is >100mIU/ml 8 weeks after completing immunisation. Responders should have an annual anti HB antibody titre check and a booster given if level <100mIu/ml.

If level 10-100mIU/ml- give booster and recheck after 4-8 weeks.

If level <10mIU/ml- course repeated once and recheck at 6-8 weeks. If still <10mIU/ml, then patient is a ‘non responder’.

If level 10-100mIU/ml then give booster.

Side effects Hypotension – monitor BP throughout infusion.  Usually only predicted following rapid infusion of large doses and should be self-limited and transient.

Nausea & vomiting – give ondansetron as above.  Continued nausea may require infusion being given over a longer period of time (e.g. over full dialysis session) or dose reduction.

Other reported side effects (from case reports):
Metabolic acidosis (correct on dialysis), Sinus congestion
Headache

Concentration/strength 40 micrograms/1ml
Stability N/A
Reconstitution instructions N/A
Additional information Store in a refrigerator

Not to be injected into the buttock (vaccine efficacy reduced).

Other preparations available if supply issues with HBVaxPro:
– Fendrix -20micrograms at 0,1,2 and 6 months
– Engerix B -40 micrograms at 0,1,2 and 6 months

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