Hepatitis A and B vaccine (combined)

How it works

It contains inactivated hepatitis A virus antigen and recombinant hepatitis B surface antigen which stimulate protective antibody responses to both viruses.

Prescribing in practice

• It provides no rapid protection and is unsuitable when immediate post-exposure cover is needed, and the full schedule must be completed for durable hepatitis B immunity.
• Defer in acute febrile illness and avoid in those with confirmed hypersensitivity to a vaccine component.
• It is given by intramuscular injection, normally into the deltoid, and not into the buttock or intradermally as this reduces the response.

Monitoring

Routine post-vaccination antibody testing is not generally required except in defined at-risk or occupational groups where checking the hepatitis B response is advised.

Counselling the patient

• Complete all doses in the schedule to gain full and lasting protection.
• Mild soreness at the injection site, headache or tiredness are common and short-lived.
• This vaccine is for prevention and does not treat existing infection.

Evidence & guidelines

Combined hepatitis A and B immunisation follows the schedules and indications set out in the UK immunisation guidance (Green Book).