How should I approach vaccination for Hepatitis B in adults who are at risk but unvaccinated?

Approach to Hepatitis B Vaccination Management in Unvaccinated Adults at Risk

Offer hepatitis B vaccination to adults who are unvaccinated and at increased risk of exposure or complications. This includes people who inject drugs, sexual partners of infected individuals, men who have sex with men, sex workers, household contacts of infected persons, people with chronic liver or kidney disease, healthcare and laboratory workers, and travellers to areas of high or intermediate hepatitis B prevalence.

Use licensed inactivated hepatitis B vaccines appropriate for the adult age group, such as Engerix B 10 micrograms or HBvaxPRO 10 micrograms. Vaccination schedules typically involve 3 doses at 0, 1, and 2 months, with a possible accelerated schedule (0, 7, and 21 days) for those needing rapid protection, followed by a booster at 12 months for ongoing immunity.

Post-vaccination serology testing is recommended at 12 months to confirm immunity, especially in high-risk groups. If immediate protection is required after exposure to hepatitis B-infected blood or body fluids, vaccination should be given promptly and may be combined with hepatitis B immunoglobulin (HBIG) where indicated.

Provide advice on safer sex practices and needle exchange, and refer to specialist services as appropriate. Vaccination related to lifestyle risks or treatment must be offered free of charge, while occupational vaccination is the employer's responsibility.