"B" Smart about Hepatits B

“B” Smart about Hepatitis B

With the introduction of new vaccines and combination vaccines, it is becoming

increasingly difficult for health care providers to keep track of minimum dosing intervals.

The New Jersey Department of Health and Senior Services (NJDHSS) would like to

stress the importance of maintaining appropriate dosing intervals to ensure that children

develop and maintain adequate antibody levels and meet the vaccination requirements

for school attendance.

There has been confusion regarding the hepatitis B vaccine schedule for children.

NJDHSS supports the recommendation of the Centers for Disease Control and

Prevention (CDC) to vaccinate children at birth. Please note the following minimum

intervals after the birth dose:

• The minimum interval between the first and second dose:

􀂾 Weeks after first dose - 1 month or 4 weeks or 28 days

• There are three minimum intervals that must be met for the third dose:

􀂾 Weeks after first dose - 4 months or 16 weeks or 112 days

􀂾 Weeks after second dose - 2 months or 8 weeks or 56 days

􀂾 Weeks after birth - 6 months or 24 weeks or 168 day

There is a four day grace period for all vaccines. Poorer immune responses are

seen in infants who complete the vaccination series prior to six months of age.

Please remember that Comvax and Pediarix should not be given to infants under the

age of six weeks. The use of Comvax prior to age six weeks can cause the

suppression of the immune response to the Hib component in Comvax. The use of

Pediarix prior to age 6 weeks can result in suppression of the immune response to

the acellular pertussis component of Pediarix.

It is acceptable to give a four-dose schedule of hepatitis B vaccine to infants. The

use of this four-dose hepatitis B vaccine schedule is necessary when giving the

monovalent hepatitis B vaccine birth dose followed by the use of combination

vaccines Comvax or Pediarix. The use of a four-dose regimen does not increase

vaccine reactogenicity and results in higher final antibody titers that may correlate

with longer duration of detectable antibody. The federal Vaccine for Children (VFC)

program provides up to four doses of hepatitis B vaccine for VFC-eligible children.

You may still use monovalent hepatitis B vaccine in a three dose series.

NJDHSS recommends the use of a customized vaccine scheduler to ensure that all

vaccines are administered according to recommended guidelines such as those

available through the New Jersey Immunization Information System (NJIIS) at

https://njiis.nj.gov/ or through the CDC at