The HepB series is now recommended for all people age 59 years and younger. Among older age groups the risk of acute hepatitis B is lower: HepB may be administered to unvaccinated adults with diabetes age 60 years and older at the discretion of the treating clinician.
In 2011, CDC first published ACIP recommendations that HepB vaccine be given to adults with diabetes because of studies showing that adults with diabetes and no other hepatitis B risk factors had twice the odds of developing acute hepatitis B compared to adults without diabetes or other risk factors. There also have been a number of outbreaks of HBV infection in settings that provide assisted blood glucose monitoring for people with diabetes.
No serologic testing or additional HepB vaccination is recommended for adults who have documentation of receiving a complete HepB series at any time in the past. For those who did not complete the vaccination series, no maximum interval between doses exists that would make the HepB vaccination series ineffective or that would require restarting the series.