Heplisav B (Hepatitis B Surface Antigen, Cpg 1018)

Heplisav B is indicated for the prevention of hepatitis B infection in adults who have not been previously immunized or who require booster protection.

• Primary immunization series for hepatitis B‑naïve adults.
• Booster vaccination for adults with documented prior hepatitis B vaccination when antibody levels have declined.
• Use in individuals at increased risk of exposure, such as healthcare workers, travelers to endemic regions, or patients with chronic liver disease.
• Administration as part of a two‑dose schedule spaced one month apart, as recommended by health authorities.

The safety profile of Heplisav B includes both common, generally mild reactions and rare, more serious events.

Common

• Pain, redness, or swelling at the injection site.
• Low‑grade fever.
• Fatigue or malaise.
• Headache.
• Nausea.

Serious

• Severe allergic reaction (anaphylaxis) with symptoms such as difficulty breathing, hives, or swelling of the face.
• Guillain‑Barré syndrome, a rare neurological disorder.
• Thrombocytopenia or other blood‑cell abnormalities.

Healthcare providers should assess individual health status before administering Heplisav B and observe standard vaccination precautions.

• Do not administer to persons with known severe allergy to any vaccine component, including CpG 1018.
• Postpone vaccination in individuals with moderate or severe acute illness until recovery.
• Evaluate immune status in patients with immunosuppressive conditions; vaccine may be less effective.
• Counsel pregnant or breastfeeding women that the vaccine is classified as pregnancy category B and is considered safe, but discuss benefits versus risks.
• Monitor for signs of anaphylaxis for at least 15 minutes after injection.
• Document previous hepatitis B vaccination history to determine need for booster dosing.

Heplisav B does not have direct pharmacologic interactions, but certain conditions and therapies may influence its administration.

Avoid

• Concurrent administration of other live vaccines; separate by at least 4 weeks.
• Use in individuals receiving high‑dose immunoglobulin therapy within 3 months, as it may reduce vaccine efficacy.

Use with caution

• Patients on immunosuppressive drugs or chemotherapy; immune response may be diminished.
• Individuals with chronic kidney disease undergoing dialysis; monitor antibody response.
• Concurrent use of antipyretics may mask mild fever post‑vaccination but does not affect immunity.