Hepatitis B immune globulin and Hepatitis B vaccine (HyperHep®, BayHep®, Infanrix hexa®)

Section 1.1

Midwives may independently prescribe, order and administer this drug.

See Protocol for Hepatitis B Immunoprophylaxis.

(HyperHep®, BayHep®, Infanrix hexa®, Engerix-B®, Recombivax HB®). Hepatitis immune globulin and Hepatitis B vaccine are administered to the infants of HBsAg positive individuals, or when otherwise indicated, within 24 hours of the birth. Subsequent doses of Hepatitis B vaccine are included in Infanrix hexa® which is given with the normal 2, 4 and 6 month immunizations as per BC Centre for Disease Control guidelines. Infants requiring hepatitis B vaccination at birth will receive a total of four doses of vaccine. Whenever immune globulin or vaccines are administered, the midwife must send a record of immunization to the physician or primary care nurse practitioner to whom care is transferred at 6 weeks postpartum.

An Emergency Drug Release (EDR) number is required from the Canadian Blood Services (formerly National Canadian Red Cross) for Hepatitis B immune globulin. The local provider of immune globulin and vaccine will obtain the number, but require advance notice and clinical information. Contact local provider of Hepatitis immune globulin and vaccine, well in advance of need, to ensure availability.

Pregnancy:

Compatible

Lactation:

Category L2 – Limited Data – Probably Compatible

Dosage and Administration:

Hepatitis B Prophylaxis for Newborns

  1. If client is known to be HBsAG positive or at high risk (i.e. IV drug user and/or sex trade worker) for hepatitis B, but negative (possible window period) or unknown for HBsAG

Give HBIg 0.5 ml immediately after birth along with dose 1 of *hepatitis B vaccine (0.5 ml IM)

Give *hepatitis B vaccine and HBIg at the same time using separate syringes and separate sites

  1. Primary caregiver or other household contact of infant has chronic hepatitis B virus infection

Give dose 1 of *hepatitis B vaccine 0.5 ml IM immediately after birth. DO NOT GIVE HBI g

  1. If client is at high risk for hepatitis B other that IV drug user and sex trade worker and status is unknown or negative

Give dose 1 of *hepatitis B vaccine 0.5 ml IM immediately after birth. DO NOT GIVE HBI g

  1. If other primary caregiver is at high risk for hepatitis B and their status is unknown or negative

Give dose 1 of *hepatitis B vaccine 0.5 ml IM immediately after birth. DO NOT GIVE HBI g.

*Hepatitis B vaccine:

Engerix-B 0.5 ml IM (10 mcg/0.5 ml) or Recombivax 0.5 ml IM (5 mcg/0.5 ml)

Infant’s subsequent immunizations will continue on normal schedule using Infanrix-Hexa which has hepatitis vaccine included in the six components. Infant would receive a total of four hepatitis B immunizations.