All following are at-risk group adults meriting Hepatitis B vaccination in low endemic areas except:
Answer is B (Diabetics on Insulin): Behavioral: Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than one sex paner during the previous 5 months): persons seeking evaluation or treatment for a sexually transmitted disease (STD): current or recent injection-drug users; and men who have sex with men. Occupational: Healthcare personnel and public-safety workers who are exposed to blood or other potentially infectious body fluids. Medical: Persons with end-stage renal disease, including patients receiving hemodialysis; person with HIV infection; and persons with chronic liver disease. Other: Household contacts and sex paners of persons with chronic HBV infection; clients and staff members of institutions for persons with developmental disabilities; and international travellers to countries with high or intermediate prevalence of chronic HBV infection. Hepatitis B vaccination is recommended for all adults in the following settings: STD treatment facilities; HIV testing and treatment facilities; facilities providing drug-abuse treatment and prevention services; healthcare settings targeting services to injection--drug users or men who have sex with men; correctional facilities; end-stage renal disease programs and facilities for chronic hemodialysis patients; and institutions and nonresidential day-care facilities for persons with developmental disabilities. Administer missing doses to complete a 3-dose series of hepatitis B vaccine to those persons not vaccinated or not completely vaccinated. These second dose should be administered 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose). If the combined hepatitis A and hepatitis B vaccine (Twinrix) is used, administer 3 doses at 0, 1, and 6 months; alternatively, a 4-dose Twinrix schedule, administered on days 0, 7, and 21 to 30, followed by a booster dose at month 12 may be used. Adult patients receiving hemodialysis or with other immunocompromising conditions should receive 1 dose of 40 pg/mL (Recombivax HB) administered on a 3-dose schedule or 2 doses of 20 Ug/mL (Engerix-B) administered simultaneously on a 4-dose schedule at 0, 1, 2, and 6 months.
Patients on chronic hemodialysis
Diabetics on insulin
Medical/nursing personnel
Patients with chronic liver disease