Hepatitis awareness month thumbnail from the CDC graphics pack


By USPPG Editorial Team | Last updated: October 2026

Hepatitis A and B vaccines prevent two very different liver infections, so practices usually stock both. Hepatitis A vaccine (Havrix) takes two doses, while hepatitis B vaccine takes two or three doses depending on the product. Meanwhile, Twinrix combines both for adults, and Pediarix adds hepatitis B to the infant DTaP and polio series.

CDC currently recommends hepatitis B vaccination for every adult 19 to 59. In contrast, it reserves hepatitis A vaccine for young children, adults at higher risk, and anyone who asks for it. Below, this guide covers who needs each vaccine, how the products differ, and where newborn guidance stands. When you’re ready to order, members can review GSK hepatitis vaccine pricing for Havrix, Engerix-B, Twinrix and Pediarix.

Table of Contents

  Key Takeaways:

  • CDC recommends hepatitis B vaccine for all adults 19 to 59, and also for older adults with risk factors.
  • Hepatitis A vaccine is routine at 12 to 23 months, and adults at risk should also receive it.
  • Heplisav-B finishes in two doses over one month, whereas adult Engerix-B takes three doses over six months.
  • Federal guidance on the newborn birth dose changed in December 2025, but a court stayed that change in March 2026.
  • Every adult 18 and older should also have a one-time hepatitis B screening with a triple panel.
  • Finally, keep all of these vaccines at 2°C to 8°C and never freeze them.

Awareness dates: Each year, May is Hepatitis Awareness Month, while May 19 is Hepatitis Testing Day. World Hepatitis Day then follows on July 28. These dates give practices a natural reason to review vaccine records and screen adults who have never had a hepatitis B test.

Hepatitis A vs. Hepatitis B at a Glance

Although both viruses attack the liver, they spread differently and carry different long-term risks. As a result, the vaccine strategy differs too.

Feature Hepatitis A Hepatitis B
How it spreads Fecal-oral route, through contaminated food, water or close contact Blood, semen and other body fluids, including from parent to infant at birth
Long-term risk Short-term (acute) illness only Can become chronic and lead to cirrhosis or liver cancer
Single-antigen vaccines in the USPPG portfolio Havrix (GSK) Engerix-B (GSK), Heplisav-B (Dynavax)
Combination vaccines Twinrix (adults) Twinrix (adults), Pediarix (infants and young children)
Routine recommendation Children 12 to 23 months Infants, unvaccinated children and teens, and adults 19 to 59

Hepatitis B also hides well. In fact, CDC estimates that 580,000 to 2.4 million people in the U.S. live with hepatitis B infection, and up to two thirds of them may not know it. For that reason, screening and vaccination work best together.

Who Should Get Hepatitis A Vaccine

First of all, CDC recommends routine hepatitis A vaccination for all children 12 to 23 months old. Unvaccinated children and teens 2 to 18 should also get catch-up doses. For adults, however, the recommendation turns on risk.

For example, adults at higher risk of infection include:

  • International travelers
  • Men who have sex with men
  • Anyone who uses or injects drugs
  • Workers with occupational exposure
  • Household members or caregivers expecting close contact with an international adoptee
  • Those experiencing homelessness

Adults with chronic liver disease or HIV face a higher risk of severe illness, so they should also receive it. In addition, CDC recommends the vaccine for pregnant patients at risk, for unvaccinated people exposed within the past two weeks, and for anyone who asks for it.

In practice, travel is the most common reason adults request it. Because patients should finish the Havrix primary dose at least two weeks before expected exposure, early scheduling matters. For a broader travel consult, also see our guide to travel vaccines for practices.

Who Should Get Hepatitis B Vaccine

Unlike hepatitis A, the adult hepatitis B recommendation is now close to universal. Specifically, CDC recommends:

  • Adults 19 to 59: vaccination for everyone, regardless of risk.
  • Ages 60 and older with risk factors: CDC also recommends vaccination.
  • Older adults without known risk: patients may still choose vaccination.
  • Under 19: catch-up vaccination when a child or teen missed the series.

Likewise, pregnancy is not a barrier. CDC lists Engerix-B, Heplisav-B and Twinrix among the vaccines providers can use when a pregnant patient needs hepatitis B protection.

Pair vaccination with screening

Since 2023, CDC has recommended hepatitis B screening for all adults 18 and older at least once in their lifetime. For the initial screen, CDC calls for a triple panel of HBsAg, anti-HBs and total anti-HBc. As a result, screening tells you who already has the infection, who is immune and who still needs vaccine.

Hepatitis B Vaccine for Newborns

Newborn guidance has been in flux, so it helps to separate the firm rules from the open questions.

What hasn’t changed

When the birthing parent tests positive for HBsAg, the infant needs hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth, at different injection sites. Also, use a single-antigen hepatitis B vaccine for the birth dose. Then test the infant for HBsAg and anti-HBs at 9 to 12 months of age, but not before 9 months.

What changed, and where it stands

For years, CDC and the American Academy of Pediatrics (AAP) both recommended a hepatitis B dose for every newborn. On December 5, 2025, however, ACIP voted for individual-based decision-making on the birth dose when the birthing parent tests negative. Shortly after, CDC adopted that vote on December 16, 2025.

Then, on March 16, 2026, a federal court stayed ACIP votes taken after June 2025. Since then, CDC’s hepatitis B page has again recommended vaccination for all infants at birth. HHS has appealed, and the appeals court had not ruled as of this update. Meanwhile, AAP has kept its universal birth-dose recommendation throughout.

Before you update protocols: check CDC’s current hepatitis B page and AAP’s guidance on the day you make changes, because the appeal could shift federal guidance again.

Once an infant has the birth dose, they can finish the series with single-antigen Engerix-B or with Pediarix. Pediarix, however, starts at 6 weeks, with doses at 2, 4 and 6 months.

Hepatitis Vaccine Products and Dosing Schedules

The table below covers the hepatitis vaccines available through USPPG’s GSK and Dynavax contracts. Still, always confirm dosing against the current prescribing information.

Product Protects against Ages Dose Standard schedule
Havrix (pediatric) Hepatitis A 12 months to 18 years 720 EL.U. / 0.5 mL 2 doses, booster 6 to 12 months after the first
Havrix (adult) Hepatitis A 19 and older 1440 EL.U. / 1 mL 2 doses, booster 6 to 12 months after the first
Engerix-B (pediatric/adolescent) Hepatitis B Birth to 19 10 mcg / 0.5 mL 3 doses at 0, 1 and 6 months
Engerix-B (adult) Hepatitis B 20 and older 20 mcg / 1 mL 3 doses at 0, 1 and 6 months
Heplisav-B Hepatitis B 18 and older 0.5 mL 2 doses at 0 and 1 month
Twinrix Hepatitis A and B 18 and older 1 mL 3 doses at 0, 1 and 6 months, or an accelerated schedule on days 0, 7 and 21 to 30 plus a 12-month booster
Pediarix DTaP, hepatitis B and polio 6 weeks to 6 years 0.5 mL 3 doses at 2, 4 and 6 months

Engerix-B or Heplisav-B for adults?

In general, most adult practices end up choosing between these two. Heplisav-B finishes in one month, so it suits patients who may not come back at six months. It also uses a CpG 1018 adjuvant and comes as a 0.5 mL dose.

Engerix-B, by comparison, covers every age group and has its own hemodialysis regimen. Specifically, for adults on dialysis, the label calls for four 2 mL (40 mcg) doses at 0, 1, 2 and 6 months, along with yearly antibody checks. Heplisav-B, on the other hand, has no established safety or effectiveness in adults on hemodialysis. When you need pricing and ordering details for Heplisav-B, see the Heplisav-B group pricing page.

When Twinrix makes sense

Twinrix suits adults who need both vaccines, such as travelers or patients with chronic liver disease. Its accelerated schedule also helps when a trip is less than a month away. Still, patients on the accelerated schedule need the 12-month booster to complete protection.

Storage and Handling

Overall, all five products share the same basic storage rules:

  • Temperature: refrigerate at 2°C to 8°C (36°F to 46°F).
  • Freezing: never freeze them, so discard any dose that has frozen.
  • Light: also keep prefilled syringes away from light.

Because freezing ruins these vaccines, place them away from freezer vents and cold spots in the unit. For a broader look at which vaccines to keep on hand, then, see our vaccine stocking guide for primary care.

Medicare Coverage Basics

Medicare also splits hepatitis vaccines across two parts. Part B covers hepatitis B vaccine, and its coverage expanded in 2025 to include people who never completed the series or whose history is unknown. Hepatitis A vaccine, by contrast, falls under Part D. Since payer rules change often, confirm coverage with your Medicare administrative contractor before you bill.

Frequently Asked Questions

Which hepatitis vaccines does an adult need?

CDC recommends hepatitis B vaccination for all adults 19 to 59, and for adults 60 and older who have risk factors. Hepatitis A vaccine, on the other hand, is for adults at higher risk, such as travelers, people with chronic liver disease or HIV, and anyone who asks for it. Twinrix, meanwhile, covers both viruses in one series for adults 18 and older.

How many doses of hepatitis B vaccine do adults need?

It depends on the product. For example, Heplisav-B takes two doses, one month apart, for adults 18 and older. By contrast, adult Engerix-B takes three doses at 0, 1 and 6 months. Adults on hemodialysis need a higher-dose Engerix-B series, because Heplisav-B has no established safety or effectiveness in that group.

Is Heplisav-B better than Engerix-B?

Neither is better for every patient, because each fits different needs. Heplisav-B finishes in two doses over one month, so more patients complete the series. Engerix-B, however, covers every age from birth, comes in a hemodialysis dosing regimen, and has decades of use. Overall, most adult practices stock the product that fits their patient mix and follow-up habits.

Can pregnant patients get the hepatitis B vaccine?

Yes. CDC lists Engerix-B, Heplisav-B and Twinrix among the vaccines providers can use when a pregnant patient needs hepatitis B vaccination. Pregnant patients at risk for hepatitis A infection or severe outcomes can also receive hepatitis A vaccine. As always, check the current CDC page before you vaccinate.

Can Pediarix serve as the hepatitis B birth dose?

No. The Pediarix label covers ages 6 weeks through 6 years, so it cannot serve as the birth dose. Instead, CDC calls for a single-antigen hepatitis B vaccine at birth. After that, infants can receive a three-dose Pediarix series at 2, 4 and 6 months.

When is Hepatitis Awareness Month?

Hepatitis Awareness Month takes place every May in the United States, and Hepatitis Testing Day falls on May 19. World Hepatitis Day then follows on July 28. As a result, many practices use these dates to review vaccine records, start catch-up series and offer hepatitis B screening.

To compare manufacturer contracts for these and other vaccines, visit the USPPG vaccine purchasing program.

Sources

This article offers general information for healthcare providers and practice administrators. It does not replace the prescribing information or current CDC guidance, so clinical decisions should follow both. Because vaccine pricing, program availability and manufacturer contracts can change, contact USPPG for the most current program details.