Prevention
All travellers should avoid contact with blood and bodily fluids by:
Avoiding unprotected sex.
Following universal precautions if working in healthcare or other higher risk settings.
Avoiding tattooing, piercing and acupuncture (unless sterile equipment is used).
Not sharing needles or other injection equipment.
Not sharing shaving equipment.
Any traveller can be at risk of an accident or require emergency treatment; infection control may be inadequate. A sterile medical equipment kit may be helpful when travelling to resource poor areas.
Hepatitis A vaccine
Vaccine schedules
Length of protection
Hepatitis A vaccine
Hepatitis B vaccine
Vaccines
Hepatitis B vaccine can be given as a single or combined vaccine. A 6-in-1 vaccine, which contains hepatitis B is offered to infants as part of the UK routine childhood immunisation schedule (not listed below). See the ‘Green Book’ for further details. Fendrix® and HBVAXPRO 40mcg® vaccines have been developed to prevent HBV infection in patients with renal insufficiency (kidney failure) (not listed below). See the ‘Green Book’ for further details.Vaccine schedules
Vaccine schedules for travellers
(Note: details for the infant routine vaccination schedule and those with renal failure are detailed above)
| Vaccine | Brand | Schedule(s) | Age range |
| Monovalent hepatitis B (adult) | Engerix B® Monovalent hepatitis B (20mcg/1ml) | Accelerated schedule of 4 doses: 0, 1, 2 and 12 months | 16 years and older |
| 3 doses: 0, 1 and 6 months | |||
| Very rapid schedule of 4 doses: 0, 7 and 21 days; 4th dose at 12 months | Very rapid schedule: licensed for adults 18 years and above (can consider ‘off license’ for 16-17-year-olds) | ||
| 2 doses of the adult dose: 0 and 6 months | 11 to 15 years | ||
| HBVAXPRO Adult® Monovalent hepatitis B (10mcg/1ml) | Accelerated schedule: 0, 1, 2 and 12 months | 16 years and over | |
| 3 doses: 0, 1 and 6 months | |||
| PreHevbri® Monovalent hepatitis B (10mcg/1ml) | 3 doses: 0, 1 and 6 months | 18 years and over | |
| HEPLISAV B® Monovalent hepatitis B (20mcg/0.5ml) | 2 doses: 0,1 months | 18 years and over | |
| Monovalent hepatitis B (paediatric) | Engerix B® Monovalent hepatitis B (10mcg/0.5ml) HBvaxPro | 3 doses: 0, 1 and 6 months | From birth to 15 years |
| Accelerated schedule: 0, 1, 2 and 12 months | |||
| HBVAXPRO Paediatric® Monovalent hepatitis B (5mcg/0.5ml) | 3 doses: 0, 1 and 6 months | From birth to 15 years | |
| Accelerated schedule: 0, 1, 2 and 12 months | |||
| Combined hepatitis A and B (adult) | Twinrix Adult® Combined hepatitis A (720ELISA units) and B (20mcg) | 3 doses: 0, 1 and 6 months | 16 years and over |
| Very rapid schedule of 4 doses: days 0, 7 and 21; 4th dose at 12 months | Licensed for adults 18 years and above (can consider ‘off license’ for 16-17-year-olds)* | ||
| Combined hepatitis A and B (paediatric) | Ambirix® Combined hepatitis A (720 ELISA units) and B (20mcg) | 2 dose schedule given 6-12 months apart | 1 to 15 years |
| Twinrix Paediatric® Combined hepatitis A (360 ELISA units) and B (10mcg) | 3 doses: 0, 1 and 6 months | 1 to 15 years |
*Off-license use listed on the UK Health Security Agency HepA/B PGD Oct 2023.
Length of protection
Length of protection
Immunocompetent adults and children who have received a primary course of immunisation, including children vaccinated according to the routine childhood schedule (8, 12 and 16 weeks) and individuals at high risk of exposure who have received a 0,1, 6 month or 0, 1, 2, 12-month schedule, do not require a reinforcing dose of hepatitis B-containing vaccine. The need for a booster dose following PreHevbri® or HEPLISAV B® has not been established.
Booster doses should be considered for:
- Healthcare workers who have not responded to a primary course.
- At the time of a significant exposure.
- Patients with kidney failure.
A booster dose should be offered to travellers receiving haemodialysis who intend to visit high risk countries and who have previously responded to the vaccine. This is particularly important if they are going to receive haemodialysis while away and they have not had a booster in the last 12 months.
A blood test to check immunity (hepatitis B surface antibody levels) is only recommended for people with kidney failure or those at risk of occupational exposure particularly healthcare and laboratory workers.
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