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©2013 UpToDate ® Print Email European Consensus Group recommendations for hepatitis B booster vaccination Children and adolescents To date no evidence supports the use of boosters in children or adolescents. It is important to ensure that the full three-dose primary course is given.* Healthcare workers If post-vaccination antibody testing suggests that adequate immunological priming has not been achieved, the following course of action is recommended: Screen for markers of present or past infection (HBsAg, anti-HBc) Administer an additional dose of vaccine Repeat anti-HBs measurement with a different assay Consider passive immunization with HB immunoglobulin after exposure Booster vaccination is not recommended for those who achieve an adequate response after primary vaccination. Intravenous drug users Testing should be considered only if the user has reduced immunocompetence. Currently there is no evidence to support booster vaccinations High-risk sexual behavior Public health services should try to identify persons with high-risk sexual behavior and ensure that they receive primary vaccination but boosters are unnecessary. Immunocompromised patients There is some justification for using boosters to maintain the anti-HBs levels above 10 mIU/mL in immunocompromised individuals as recommended for dialysis patients by the US Advisory Committee on Immunization Practices. Additional or double doses are recommended for nonresponders. Attempts should be made to administer the vaccine when the patient's immune system is likely to be functioning maximally (eg, before initiating hemodialysis). Post-vaccination testing every 6 to 12 months is advisable Residents of mental institutions No booster vaccinations are recommended. However, staff who are in close contact with residents should receive primary vaccination. Close contacts of HBsAg carriers/immigrants Close contacts of HBsAg carriers should receive primary vaccination in the absence of serologic evidence of HBV infections. No further boosters are necessary. * A two-dose regimen has been approved for Recombivax in adolescents. Adapted from The European Consensus Group on Hepatitis B Immunity. Lancet 2000; 355:561.