Heplisav B (Hepatitis B Surface Antigen, Cpg 1018)

Heplisav B is indicated for the prevention of hepatitis B infection in specific populations.

• Adults 18 years and older who have not been previously vaccinated against hepatitis B.
• Adolescents 12–17 years of age who are at risk for hepatitis B exposure.
• Individuals with occupational exposure risk, such as health‑care workers.
• Persons with chronic liver disease, diabetes, or other conditions that increase susceptibility to hepatitis B.
• Travelers to regions where hepatitis B is endemic.

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

Common

• Pain, redness, or swelling at the injection site.
• Low‑grade fever.
• Headache or fatigue.
• Mild muscle aches.
• Nausea.
• Mild joint pain.
• Transient rash.

Serious

• Severe allergic reaction (anaphylaxis).
• Guillain‑Barré syndrome (rare).
• High fever with chills.
• Neurological symptoms such as weakness or numbness.
• Severe injection site reaction (e.g., necrosis).
• Thrombocytopenia.

Before administering Heplisav B, healthcare providers should consider several precautionary factors to ensure safe use.

• Known hypersensitivity to any component of the vaccine, including the CpG 1018 adjuvant.
• History of severe allergic reaction to a previous hepatitis B vaccine.
• Immunocompromised patients, as response may be reduced.
• Pregnancy and breastfeeding status, because safety data are limited.
• Acute moderate or severe illness at the time of vaccination.
• Use in individuals younger than 12 years, which is not approved.

Heplisav B may interact with other agents; certain combinations should be avoided while others require careful monitoring.

Avoid

• Concurrent administration of other live vaccines (e.g., measles, mumps, rubella).
• Simultaneous use of immunosuppressive biologics that could blunt vaccine response.
• High‑dose chemotherapy administered within 2 weeks of vaccination.

Use with caution

• Antiviral therapy for chronic hepatitis B, as it may affect serologic testing.
• Systemic corticosteroids, which may reduce immunogenicity.
• Blood products or immunoglobulins given within 4 weeks of vaccination.
• Patients receiving interferon therapy.
• Interferon therapy may alter immune response to the vaccine.