Hepatitis B Vaccine (Heplisav-B®)


Indications for Prior Authorization:

  • Prevention of infection caused by all known subtypes of Hepatitis B virus in adults 18 years of age and older

Prior Authorization Criteria:

  • Patient is 18 years of age or older
  • Patient does not have a history of severe allergic reaction (such as anaphylaxis) after a previous dose of any Hepatitis B vaccine or to any component of Heplisav-B, including yeast


  • Administer 0.5 mL intramuscularly as a two dose series, the second injection should be administered one month after the initial vaccination


  • 2 doses

Last review date: April 22, 2019

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