Global hepatitis B vaccine shortages have had a severe impact on UK supply. Despite measures to protect paediatric vaccine for the neonatal selective immunisation programme for babies born to infected mothers, vaccine stock has reached critically low levels. These infants are the priority for timely vaccination and should follow the recommended schedule of vaccination at birth, four weeks and eight weeks of age.
To preserve scarce monovalent vaccine for the birth and four-week doses and to prevent delays in administering the eight-week dose, the hexavalent vaccine, Infanrix hexa (DTaP/IPV/Hib/HepB) can now be ordered from vaccine holding centres (i.e. ordering for Infanrix hexa has opened earlier than planned for these babies).
From 1 September 2017, babies who have already started on a course of hepatitis B vaccine at birth should be given Infanrix hexa in place of EngerixB 10mcg or HBVaxPRO 5mcg at eight weeks of age even if born before 1 August 2017. This is a change from the previous eligibility for Infanrix hexa vaccine. To avoid confusion for professionals and parents, if a baby receives Infanrix hexa at eight weeks of age, they should complete the routine childhood course with Infanrix hexa vaccine.
The routine and selective infant hepatitis B vaccination programmes for babies born on and after 1 August remain unchanged as they are already recommended to get Infanrix hexa at eight weeks of age.
If no monovalent paediatric hepatitis B vaccine is available for the birth dose and four- week dose, alternative hepatitis B containing vaccines should be given without delay. A further but last option for babies who have received the birth dose on time but for whom no supplies of monovalent and/or combined Hep A/B vaccine are available for the four-week dose would be to bring forward the first dose of Infanrix hexa vaccine to six weeks of age.
Manufacturers are aware of the priority for this group particularly those born to infected mothers and will release individual doses of vaccine above any ordering restrictions if the requester provides this justification.
Additional information on:
The introduction of the hexavalent vaccine into the childhood immunisation schedule was the subject of a recent Scottish Vaccine Update which can be accessed at http://www.hps.scot.nhs.uk/immvax/resourcedetail.aspx?id=3308.