Hepatitis B Vaccine

(Hep B Vaccine)

by Krisha McCoy, MS

What Is Hepatitis B?

Hepatitis B is a disease caused by the hepatitis B virus (HBV). This virus attacks the liver. The disease can cause:

Lifelong infection
Cirrhosis of the liver
Liver cancer
Liver failure
Death

HBV is spread through the blood or other body fluids of an infected person.

Certain factors increase the risk of developing hepatitis B, including:

Having sex with someone infected with HBV
Having multiple sexual partners
Injecting illegal drugs
Having male homosexual sex
Living in the same house as someone with chronic hepatitis B
Coming in contact with human blood
Working in the home of someone who is developmentally disabled
Having hemophilia
Traveling to areas where hepatitis B is common
Having parents born in Southeast Asia, Africa, the Amazon Basin in South America, the Pacific Islands, or the Middle East

About 30% of people with hepatitis B will not have symptoms. For people who do, symptoms may include:

Yellowing of the skin and eyes ( jaundice)
Fatigue that lasts for weeks or even months
Abdominal pain in the area of the liver (upper right side)
Loss of appetite
Nausea
Vomiting
Joint pain
Low-grade fever
Dark urine and light-colored stool
Widespread itching
Rash

Symptoms generally occur about 12 weeks after exposure. They can occur anywhere from 9-21 weeks after exposure. Most hepatitis B infections clear up within 1-2 months without treatment. But when an infection lasts more than six months, it can develop into chronic hepatitis B. This can lead to serious complications, even death.

Chronic hepatitis B can be treated with antiviral drugs.

What Is the Hepatitis B Vaccine?

The hepatitis B vaccine is produced by inserting a gene for HBV into yeast. The yeast is grown, harvested, and purified. The vaccine is given as an injection into the muscle.

Who Should Get Vaccinated and When?

Children

Newborns routinely receive the first dose of the hepatitis B vaccine before leaving the hospital. If the mother is infected with the virus, the dose is given within 12 hours of birth. Two more injections are given to all infants at:

1-2 months
6-18 months

Depending on the type of vaccine, some babies may receive 4 doses.

Children and teens (aged 18 years or younger) who have not been immunized as babies can also get the vaccine. For children aged 11-15 years, there is a two-dose series available, called Recombivax HB.

Adults

It is recommended that adults (aged 18 years or older) get vaccinated if they are at high risk for hepatitis B. High risk includes:

Having multiple sex partners
Getting treatment or counseling for a sexually transmitted disease (STD)
Being a man who has sex with other men
Being an IV drug user or having a history of injecting drugs
Having chronic kidney disease, liver disease, or HIV
Undergoing dialysis
Having diabetes (if younger than 60 years old)
Having a job where you might be exposed to HBV-infected blood or body fluids (eg, medical facility, correctional facility)
Working or living in an institution for the developmentally disabled
Living with or working with people who have chronic HBV infection
Traveling to areas where there is a high rate of HBV infection

What Are the Risks Associated With the Hepatitis B Vaccine?

All vaccines are capable of causing serious problems, such as a severe allergic reaction.

Most people who get the hepatitis B vaccine do not have problems. Some may have mild problems, including soreness where the shot was given and fever.

Acetaminophen (eg, Tylenol) is sometimes given to reduce pain and fever that may occur after getting a vaccine. In infants, the medicine may weaken the vaccine's effectiveness. Discuss the risks and benefits of taking acetaminophen with the doctor.

Who Should Not Get Vaccinated?

You should not get the vaccine if you:

Had a life-threatening allergic reaction to baker's yeast or to a previous dose of hepatitis B vaccine
Are moderately or severely ill—Wait until you recover to get the vaccine.

What Other Ways Can Hepatitis B Be Prevented Besides Vaccination?

Other than getting the hepatitis B vaccine, the best methods of preventing an HBV infection include:

Practicing safe sex
Getting a blood test for hepatitis B if you are pregnant
Avoiding illegal drugs
Not using other people's personal care items that may have blood on them (eg, razors, toothbrushes)
Considering the risks before getting a tattoo or body piercing
Following safety precautions when handling needles or other sharp objects

What Happens in the Event of an Outbreak?

In the event of an outbreak, all susceptible people should be offered the vaccine.

WHERE CAN I GET MORE INFORMATION?

National Digestive Diseases Information Clearinghouse
http://digestive.niddk.nih.gov/

National Immunization Program
Centers for Disease Control and Prevention
http://www.cdc.gov/vaccines/

REFERENCES:

Baker CJ, Pickerling LK, Chilton L, et al. Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011. Ann Intern Med. 2011;154(3):168-173.

Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2011. MMWR. 2011;60(5).

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12):1-110.

Hepatitis B. National Center for Infectious Diseases website. Available at: http://www.cdc.gov/ncidod/ . Accessed February 6, 2007.

Hepatitis B. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/diseases/hepatitis/b/factvax.htm . Accessed February 6, 2007.

Hepatitis B vaccination. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/hepb/default.htm . Accessed February 6, 2007.

Recommended immunization schedules for persons aged 0-6 years—United States, 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov... . Published December 23, 2011. Accessed February 10, 2012.

Vaccine information statement: hepatitis B vaccine. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep-b.pdf . Updated February 2, 2012. Accessed February 10, 2012.

1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.

10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Prymula R, Siegrist C, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet . 2009;374(9698):1339.

Last reviewed June 2012 by Lawrence Frisch, MD, MPH
Last Updated: 06/19/2012

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