Indications

Hepatitis B vaccine is indicated in individuals at high risk of contracting hepatitis B. In the UK, hepatitis B vaccination is indicated in the following groups:

• babies whose mothers have had hepatitis B during pregnancy or are positive for hepatitis B surface antigen (regardless of e-antigen markers); hepatitis B vaccination is started immediately on delivery and hepatitis B immunoglobulin given at the same time (but preferably at a different site). Babies whose mothers are positive for hepatitis B surface antigen and for e-antigen antibody should receive the vaccine only (but babies weighing 1.5 kg or less should also receive the immunoglobulin regardless of the mother's e-antigen antibody status)
• parenteral drug abusers, their sexual partners, and household contacts
• individuals who change sexual partners frequently
• close family contacts of a case or carrier
• individuals with haemophilia, those receiving regular blood transfusions or blood products, and carers responsible for the administration of such products
• patients with chronic renal failure including those on haemodialysis
  • haemodialysis patients should be monitored for antibodies annually and re-immunised if necessary
  • home carers (of dialysis patients) should be vaccinated
• individuals with chronic liver disease
• healthcare personnel (including trainees) who have direct contact with blood or blood-stained body fluids or with patients' tissues
• other occupational risk groups such as morticians and embalmers
• staff and patients of day-care or residential accommodation for those with severe learning difficulties
• staff and inmates of custodial institutions
• those travelling to areas of high or intermediate prevalence who are at increased risk or who plan to remain there for lengthy periods
• families adopting children from countries with a high or intermediate prevalence of hepatitis B
• foster carers

Reference:

1. BNF 14.4