Hepatitis B Vaccine

Hepatitis B [hep-uh-ty-tiss “B”] is a viral disease that causes liver inflammation. People who are infected as children are more likely to develop permanent liver problems. Most people in the U.S. get their first Hepatitis B vaccine as soon as they are born.

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Table of Contents for Hepatitis B

OverviewSigns & SymptomsHepatitis B ImmunizationHepatitis B Vaccine Side Effects

What is Hepatitis B?

Hepatitis B is an infection with the hepatitis B virus (HBV) that causes liver inflammation and damage. It is a contagious disease that spreads in blood and body fluid. Hepatitis B infections can cause long-term health problems like cirrhosis, liver cancer, liver failure, and death.

Hepatitis B can be a short-term or long-term illness:

Acute Hepatitis B: Mild illness that lasts a few weeks. The body usually gets rid of the virus on its own, but not always, and it can lead to chronic infections.
Chronic Hepatitis B: Lifelong illness that occurs when the virus stays in the body forever. The risk decreases with age. Chronic infections occur in about 25-50% of children under 5 years old and it decreases to 6-10% of people who are infected after age 6.

How long is Hepatitis B contagious?

Hepatitis B is a highly-contagious virus that can survive outside the body for up to 7 days. It is about 50-100X more contagious than HIV. The disease is contagious as long as the virus is replicating in the liver, which can be as short as a few weeks or as long as a lifetime.

How do you get Hepatitis B?

Hepatitis B spreads from person-to-person in blood, semen, vaginal fluids, or other body fluid of an infected person enters the body of a non-infected person. About two-thirds of people are infected by sex.
Hepatitis B does NOT normally spread in contaminated food or water, sharing eating utensils, breastfeeding, coughing, or sneezing.

Transmission of Hepatitis B can occur in several ways, for example:

Birth (infected mother to a baby)
Sex with a person who has Hepatitis B
Dirty needles
Sharing razors or toothbrushes with an infected person
Touching the blood or open sores of an infected person
Needle-sticks in nurses
Blood transfusions (hemodialysis patients)

How many people get Hepatitis B?

There were about 19,200 new cases of Hepatitis B in the United States in 2014. This likely underestimates the actual number of cases because some people do not have symptoms or get medical attention.

The rates of Hepatitis B infections have decreased by 82% since 1991, when routine immunization of children began. There are around 850,000 to 2.2 million people living in the U.S. with chronic hepatitis B.

What should I do if I was exposed?

Hepatitis B infections can sometimes be prevented in non-immune people who get the Hepatitis B vaccine or a shot called “HBIG” (Hepatitis B immune globulin) within 24 hours of exposure.

Can I get Hepatitis B more than once?

No. Once you recover from Hepatitis B, you should be immune to it for the rest of your life. Some people never recover from Hepatitis B and and they remain infected for their entire life.

How can I prevent Hepatitis B?

Hepatitis B is preventable with a vaccine, usually given as 3 or 4 shots over a 6-month period. People who are immunized against Hepatitis B develop antibodies that fight the virus and prevent infection. Children in the U.S. usually get their first shot of the Hepatitis B vaccine at birth.

Does Hepatitis B always cause symptoms?

No. Around 70% of adults develop symptoms, but most children under 5 years old do not show symptoms of Hepatitis B. People who do not have symptoms are still very contagious.

What are the symptoms of Hepatitis B?

Fever
Fatigue
Loss of appetite
Nausea
Vomiting
Abdominal pain
Dark urine
Clay-colored bowel movements
Joint pain
Jaundice (yellowing of skin and eyes)

How soon do symptoms appear?

The average time for symptoms to appear is 90 days after exposure to the virus, but the incubation period ranges from 6 weeks to 6 months.

How long do symptoms last?

Symptoms usually last for a few weeks, but some people experience symptoms for up to six months. The body usually gets rid of the virus, but not always. Some people develop chronic Hepatitis B infections, but they may not have any symptoms for as long as 20 or 30 years.

How serious is Hepatitis B?

About 15-25% of people with chronic Hepatitis B develop serious liver problems like cirrhosis (scarring of the liver) or liver cancer. Some people do not experience serious symptoms, but they can still spread very serious infections to other people.

Can Hepatitis B cause death?

Yes. Every year, about 1,800 people in the U.S. die from Hepatitis B-related liver disease.

Is there a cure for Hepatitis B?

No. There is no medication to cure Hepatitis B and doctors usually recommend bed rest, adequate nutrition, and fluids. Some people need to be hospitalized. People with chronic Hepatitis B infections will need routine check-ups to monitor their liver function.

What is the Hepatitis B vaccine?

The Hepatitis B vaccine is an immunization against all known subtypes of the Hepatitis B virus (HBV). It is given in a series of three separate shots, with the first shot usually given immediately after birth. Some vaccines only immunize against Hepatitis B, while others are combined with vaccines against diseases like polio, diphtheria, tetanus, pertussis, hepatitis A, or Hib (Haemophilus influenzae).

How effective is the Hepatitis B vaccine?

Full immunization with 3 doses of the vaccine will prevent 90% of Hepatitis B infections in people who are exposed to the virus. Protection should last for at least 20 years in people who received their first Hepatitis B immunization before they were 6 months old.

What is the immunization schedule for Hepatitis B?

The immunization schedule for Hepatitis B for people under 19 years old is a series of three 0.5-mL shots. The 1st shot is given shortly after birth, the 2nd at 1-2 months old, and the 3rd shot at 6-18 months old.

Immunization may be delayed in infants who are premature, very sick, or low birth weight (under 2,000 grams).

Booster shots are not recommended for Hepatitis B, except for some high-risk adults over 19 years old. The immunization is a series of three 1-mL shots on a 0-month, 1-month, and 6-month schedule.

What are Hepatitis B vaccine names?

Engerix-B® (HepB)
Recombivax HB® (HepB)
Pediarix® (HepB-DTaP-IPV)
Twinrix® (HepB-HepA)
Comvax (HepB-Hib)

Is the Hepatitis B vaccine safe?

Yes. The risk of side effects depends on the type of vaccine. The combined vaccines are typically more likely to cause side effects, although the risk of a serious problem is still extremely low.

To learn more about the side effects associated with the hepatitis B vaccines, please visit this page: Hepatitis B Vaccine Side Effects.

What are the most common vaccine side effects?

The most common Hepatitis B vaccine side effect is soreness where the shot was injected. Up to 10% of people experience fatigue, dizziness, headache, or a fever over 100ºF.

What are the most severe vaccine side effects?

The following is a list of severe side effects that have been reported in people who received the Hepatitis B. These side effects are so rare, it is unknown if they were actually caused by the vaccine.

Abnormal liver function tests
Allergic reaction
Angioedema
Apnea (temporarily stop breathing)
Asthma-like symptoms
Back pain
Bell’s palsy
Eczema
Encephalitis
Enlarged lymph nodes
Erythema multiforme
Facial paralysis
Fainting
Flu-like symptoms
Gastrointestinal constipation, diarrhea, vomiting
Guillain-Barré syndrome
Hair loss
Heart palpitations
Joint pain
Meningitis
Migraine
Multiple sclerosis
Nerve damage
Neuritis
Neuropathy including hypoesthesia (numbness)
Optic neuritis
Paralysis
Seizures
Serum sickness
Shoulder Injury Related to Vaccine Administration
SIRVA
Skin reactions
Stevens-Johnson Syndrome
Thrombocytopenia
Transverse myelitis
Guillain-Barré syndrome
Upper respiratory tract infection
Vasculitis
Weakness

Where can I get more information?

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