hepatitis a vaccine + hepatitis b vaccine: clinical use

Prescribing considerations

• Confirm that protection against both infections is required and select the age-appropriate formulation.
• Postpone vaccination during acute severe febrile illness; minor illness alone is not necessarily a contraindication.
• Immune suppression, haemodialysis, obesity, smoking, older age or some chronic conditions may reduce immunogenicity.
• Not recommended for post-exposure prophylaxis such as after a needlestick injury.
• Record the product name and batch number.

Contraindications and cautions

• Hypersensitivity to an active component, excipient or neomycin.
• Hypersensitivity after a previous hepatitis A or hepatitis B vaccine.

Monitoring

• Observe for immediate hypersensitivity and ensure anaphylaxis treatment is available.
• Take precautions against injury from syncope, particularly in adolescents.
• Consider post-vaccination serology where there is a substantial risk of inadequate hepatitis B protection.

Clinical pharmacology

Combines aluminium-adsorbed, purified inactivated hepatitis A antigen with aluminium-adsorbed recombinant hepatitis B surface antigen. It induces specific anti-HAV and anti-HBs antibody responses; pharmacokinetic assessment is not applicable to vaccines.

Formulation and product differences

• The adult pre-filled suspension is licensed from 16 years of age.
• The paediatric pre-filled suspension is licensed from 1 year up to and including 15 years.
• Both are turbid white suspensions requiring thorough resuspension and may contain traces of neomycin.