NEODOSE

INDICATIONS

Immunoprophylaxis against hepatitis B. Premature infants who have received the recommended three doses of vaccine have antibody levels in the protective range at 9 to 12 months, regardless of gestational and birthweight. Safe for use in infants born to HIVpositive mothers, although it may be less effective.

CONTRAINDICATIONS

Contraindicated in patients with a serious allergic reaction (eg, anaphylaxis) after a previous vaccine dose or to a component of the vaccine, including yeast. Vaccination should be deferred in patients with moderate or severe acute illness, with or without fever. Immunocompromised patients may have a suboptimal response to the vaccine . Apnea may occur in some premature infants following IM administration. Syncope, at times associated with other neurologic signs (such as tonic-clonic movements, paresthesias) may occur with the administration of injectable vaccines, including hepatitis B vaccine. Available evidence suggests that hepatitis B vaccination is not associated with an increased risk for development or relapse of multiple sclerosis. Latex-sensitive individuals; use caution as the tip caps of the prefilled Engerix-B® syringes may contain natural rubber latex.

ADVERSE EFFECTS

The only common side effect is soreness at the injection site. Fever greater than 37.7 degrees C occurs in 1% to 6%.

ADMINISTRATION

The vaccine may be administered subcutaneously in patients at risk for hemorrhage following IM injection, but the immune response may be lower. A 22- to 25-gauge needle should be used. The appropriate needle length is 7/8” to 1” for infants.

MONITORING

Testing for immunity 3 months after completion of the vaccination series is recommended for infants born to HBsAg-positive mothers and, perhaps, for premature infants who received an early first dose.