Adult haemodialysis patients and patients with severely impaired renal function who expect to have dialysis are recommended to receive larger-than-usual doses of hepatitis B vaccine

Adult haemodialysis or pre-dialysis patients are recommended to receive larger-than-usual doses of hepatitis B vaccine — either: 

• 1.0 mL of Engerix-B adult formulation (20 µg) in each arm at each schedule point (that is, a double dose on each occasion) in a 4-dose schedule at 0, 1, 2 and 6 months,⁸ or
• a single dose of H-B-Vax II dialysis formulation (40 µg) on each occasion in a 3-dose schedule at 0, 1 and 6 months

Dialysis patients and patients with severely impaired renal function who expect to have dialysis may be at increased risk of acquiring hepatitis B virus infection. They may also respond less well to vaccination than other people.

Levels of antibody to hepatitis B surface antigen should be checked after the vaccination course. See Serological testing after hepatitis B vaccination.

See also Vaccination for people who are immunocompromised.