Babies That Need To Stay In Hospital
If your baby needs to stay in hospital they should receive the second dose of vaccine when they reach 4 weeks old and then continue to follow the schedule below.
Keep a record of your babys appointments and vaccination dates. These will also be recorded by your midwife, health visitor, practice nurse and GP in your babys Red Book . Bring your childsRed Book to every appointment.
If you have questions you can speak to your midwife, health visitor, practice nurse or GP.
Vaccine Schedule For Preemies
Parents of premature babies may be concerned that their newborns are simply too fragile to adhere to the recommended childhood vaccination schedule. However, its not only perfectly safe for preemie to get their shots on timeits recommended. After all, if your preterm baby gets any of the infections that vaccines can prevent, their chance of suffering disease-related problems skyrockets. The one exception: If your baby weighs less than 4 pounds, 6 ounces , the AAP recommends waiting to vaccinate against hepatitis B until your little ones 1-month checkupor at the time of dischargewhichever comes first.
Why Is The Hepb Vaccine Recommended
People who dont know they’re infected can spread the hepatitis B virus. So it cant be avoided just by being careful. That’s why health experts recommend that all babies get the vaccine right from birth.
The HepB injection usually creates long-term immunity. Most infants who get the HepB series are protected from hepatitis B infection beyond childhood, into their adult years.
Eliminating the risk of infection also decreases risk for cirrhosis of the liver, chronic liver disease, and liver cancer.
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How To Get Vaccinated Against Hepatitis B
All babies in the UK born on or after 1 August 2017 are given 3 doses of hepatitis B-containing vaccine as part of the NHS routine vaccination schedule.
These doses are given at 8, 12 and 16 weeks of age.
Babies at high risk of developing hepatitis B infection from infected mothers are given extra doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age.
If you think you’re at risk and need the hepatitis B vaccine, ask your GP to vaccinate you, or visit any sexual health or genitourinary medicine clinic.
If your job places you at risk of hepatitis B infection, it’s your employer’s responsibility to arrange vaccination for you, rather than your GP. Contact your occupational health department.
How Do I Know That I Am Protected Against Hepatitis B
If you have never been tested for hepatitis B, your doctor can arrange a blood test to check your hepatitis B status before you are given the vaccination course. The prescreening blood test will check you have not already had exposure to the hepatitis B virus.
If you have had a full course of hepatitis B vaccination in the past then there is a good chance that you are protected now. Also, if you have had hepatitis B before and cleared the infection you are immune to hepatitis B.
After vaccination, a post vaccination blood test is available to check that the vaccine has been effective. Your doctor can order this test for you. This blood test is not routinely recommended for children as the hepatitis B vaccine is highly effective.
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Important Information About Vaccine And Hepatitis B Immunoglobulin Shot Administration
Where available, the hepatitis B birth-dose and HBIG should be administered within 24 hours of birth in order to prevent the transmission of hepatitis B from mother to child. It is very important that the shots be given in opposite limbs, to ensure the highest effectiveness. Please see chart above for more information.
Hepatitis B Vaccine: Canadian Immunization Guide
For health professionals
Last partial content update : May 2022
The footnotes in and the accompanying text description for the figure have been revised to align with the corresponding figure in Protocole d’immunisation du Québec, 5e édition from which it was adapted.
Last complete chapter revision :
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What Other Drugs Interact With Hepatitis B Vaccine
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.
- Severe Interactions of Hepatitis B Vaccine include:
- belimumab
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.
Who Should Receive Hepatitis B Vaccination
- All newborns before hospital discharge. Infants born to hepatitis B-positive women need hepatitis B vaccine and HBIG within 12 hours of birth.
- All children and adolescents not previously vaccinated.
- Children born in the U.S. to individuals born in a country with high hepatitis B endemicity.
- All individuals at risk of hepatitis B infection:
- Sex partners of hepatitis B-positive persons
- Sexually active persons who are not in a long-term, mutually monogamous relationship
- Persons seeking evaluation or treatment for a sexually-transmitted disease
- Men who have sex with men
- Persons who inject drugs
- Household contacts of hepatitis B-positive persons
- Persons born in countries where hepatitis B infection is endemic should be tested and vaccinated if susceptible
- International travelers to regions with high or intermediate rates of endemic hepatitis B infection
- Health care and public safety workers that may be exposed to blood or blood-contaminated body fluids
- Residents and staff of facilities for developmentally disabled persons, corrections facilities, and other facilities that serve adults at risk for hepatitis B infection
- Persons with end-stage renal disease, including pre-dialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
- Persons with chronic liver disease
- Persons to age 60 years with diabetes
- Persons with HIV infection
- All other persons seeking protection from hepatitis B infection.
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Facts About Hepatitis B
- Two billion people, or one in three, have been infected with hepatitis B worldwide. Of these, almost 300 million live with chronic hepatitis B. This means about 1 of every 26 people throughout the world are living with a chronic hepatitis B infection.
- Each year about 900,000 people die from hepatitis B worldwide, and about 2,000 of these deaths occur in the United States.
- Hepatitis B is transmitted through blood and is 100 times more infectious than HIV. An estimated one billion infectious viruses are in one-fifth of a teaspoon of blood of an infected person, so exposure to even a very small amount, such as on a shared toothbrush, can cause infection.
- Hepatitis B is sometimes referred to as the silent epidemic because most people who are infected do not experience any symptoms.
- Liver cancer accounted for about 5% of cancer deaths in the U.S. during 2020.
- Almost half of liver cancers are caused by chronic infection with hepatitis B.
- The World Health Organization recommends the inclusion of hepatitis B vaccine in immunization programs of all countries in 2019, more than 8 of 10 infants born throughout the world received three doses of hepatitis B vaccine.
Us Children And Adult Hepatitis B Vaccine Schedules
*Please note that the first dose should be given as soon as possible. Additional doses require minimum time intervals between doses in order for the vaccine to be effective.
3-Dose Vaccine Series for Children and Adults
The hepatitis B vaccine is an injection that is generally given in the arm as a three-dose series on a 0, 1, and 6-month schedule. Alternative schedules may be considered, noting that a third dose at 6 months, meeting minimum intervals between doses, is needed for maximum, long-term protection. Completing the hepatitis B vaccine series, preferably beginning at birth, will ensure protection against hepatitis B, hepatitis delta and lower the lifetime risk of liver cancer. Greater than 90% of babies and up to 50% of young children who are not vaccinated and are infected with hepatitis B will have lifelong infection, which makes the birth dose essential to their protection.
There are four, 3-dose vaccine brands approved in the U.S.
- PreHevbrio PreHevbrio is only approved for adults age 18 and over.
2-Dose Vaccine Series
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How Do Inactivated Viral Vaccines Work
Inactivated viralvaccines are sterile biologic products that provide immunity against viral infections. Inactivated viral vaccines work by stimulating the bodys immune system to produce antibodies against specific types of viruses, and protect a person from becoming infected when exposed to these viruses.
In the case of SARS-CoV-2 coronavirus that causes respiratory illness and has led to the COVID-19 pandemic, vaccines do not entirely prevent infection but protect vaccinated individuals from serious illness and hospitalization from the disease.
Inactivated viral vaccines contain particles of proteins or genetic material from viruses. Inactivated viral vaccines may also contain substances that preserve and stabilize the vaccine, and enhance immune response. Some viral vaccines are delivered in inactivated harmless viruses such as human adenovirus.
Inactivated viral vaccines may be made from:
- Surface proteins of the viruses enable the virus to hold on to a human cell, enter inside and replicate.
- Modified RNA particles from the virus can enter host cells and induce the production of viral antigen, which stimulates an immune response from the body.
- Recombined DNA material from multiple strains and subtypes of viruses, killed to eliminate disease-causing capability.
Currently, inactivated viral vaccines approved by the FDA protect against viral infectious diseases that include:
- Coronavirus disease , caused by SARS-Cov-2 virus
Adults
For Adults And Children
This vaccine schedule involves three doses within 2 months, followed by a booster dose at 1 year.
The initial accelerated doses provide immediate protection from HBV, and the booster dose helps provide long-term protection.
Below is the accelerated vaccination schedule approved for both adults and children:
| Vaccine series | |
|---|---|
| 2 months after the first dose | 1 year after the first dose |
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Infants Are Recommended To Receive 4 Doses Of Hepatitis B Vaccine
Infants are recommended to receive 4 doses of hepatitis B vaccine:
- 1 dose of monovalent paediatric formulation hepatitis B vaccine at birth
- 3 doses of a paediatric hepatitis Bcontaining vaccine at 2, 4 and 6 months of age .
Infants can receive the dose scheduled at 2 months of age as early as 6 weeks of age. They should still receive their next scheduled doses at 4 months and 6 months of age.
Who Should Receive The Hepatitis B Vaccine
For most people, the hepatitis B vaccine is safe and effective. About 90% of people who receive three vaccine doses are protected against hepatitis B for over 30 years.
The CDC’s Advisory Committee on Immunization Practices recommends the hepatitis B vaccine for the following groups:
- All babies, starting just after birth
- Children and adolescents under 19 years old
- Adults ages 1959 who have not previously completed vaccination
- Adults ages 60 and over with a high risk of contracting HBV
Adults ages 60 and over who do not have any hepatitis B risk factors can receive the hepatitis B vaccine, but it is optional.
Hepatitis B spreads when the bodily fluids of an infected person enter another person’s body. Sexual contact is one way it can be spread. A person with HBV can spread it to their baby during childbirth. Other ways in which HBV may be transmitted include:
- Sharing medical equipment, whether at home or in a hospital setting, with a person who has an HBV infection
- Sharing syringes with a person who has hepatitis B, such as during injection drug use or at-home piercing or tattooing
- Sharing personal items, such as razors or toothbrushes, with someone who has hepatitis B
- Coming into contact with the sores or blood of a person who has hepatitis B
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Hepatitis B Vaccination In Pregnancy
Hepatitis B infection in pregnant women may result in severe disease for the mother and chronic infection for the baby.
This is why the hepatitis B vaccine is recommended for pregnant women who are in a high-risk category.
There’s no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.
And, as it’s an inactivated vaccine, the risk to the unborn baby is likely to be negligible .
Are Hepatitis B Virus Infections Easily Avoided
Large quantities of hepatitis B virus are present in the blood of people with hepatitis B in fact, as many as one billion infectious viruses can be found in a milliliter of blood from an infected individual. Therefore, hepatitis B virus is transmitted in the blood of infected individuals during activities that could result in exposure to blood, such as intravenous drug use, tattooing, or sex with people who are infected. However, it is also possible to catch hepatitis B virus through more casual contact, such as sharing washcloths, toothbrushes or razors. In each of these cases, unseen amounts of blood can contain enough viral particles to cause infection. In addition, because many people who are infected don’t know that they are infected, it is very hard to avoid the chance of getting infected with hepatitis B virus.
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Other Reported Adverse Events And Conditions
While serious events and chronic illnesses such as chronic fatigue syndrome, multiple sclerosis, Guillain-Barré syndrome, rheumatoid arthritis and sudden infant death syndrome have been alleged or reported following HB vaccination, no evidence of a causal association has been demonstrated in a number of studies.
When Babies Get The Hepb Vaccine
Its often recommended that babies get the first of the three-dose vaccine within 12 to 24 hours of birth. A second dose is recommended between 1 and 2 months, with the last dose coming in between 6 and 18 months. There can be slight variations on the timing of Babys first dose depending on their weight and/or the birthing parents hepatitis B status. Some providers might suggest waiting until your little ones first doctors visit before they get their first shot.
HebB Vaccine Schedule:
- First Dose: At birth
- Second Dose: Between 1 and 2 months
- Third Dose: Between 6 and 18 months
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Testing Your Baby For Infection
Each year, a very small number of babies may develop infection so your baby will be offered a blood test when they are 1 years old. This is to check that the course of vaccines have prevented them from developing hepatitis B.
There are 2 ways that this may be done and your GP, health visitor or practice nurse will advise you which test your baby will have:
If they do have the infection, they will be referred to a specialist for treatment to reduce their risk of developingserious liver disease.
If a young infant is infected, they are more likely to develop long lasting infection without any signs or symptoms of infection. Even if your baby has no signs or symptoms of infection they should still have the blood test.
Infection can be prevented in 90% of cases if the first dose of vaccine is given at birth and the full course of vaccines is completed on time.
General Information About Vaccination Outside The Us
In developing countries, the pentavalent vaccine, a combination 5-in-one vaccine that protects against five diseases, diphtheria, pertussis, tetanus, Hib and hepatitis B, may be given to babies more than 6 weeks of age, and can be given up to 1 year of age. The first dose is given at 6 weeks, and the second and third doses are given at 10 and 14 weeks of age. The pentavalent vaccine may be made available free of charge with the support of GAVI, the vaccine alliance. Check the GAVI country hub to see the resources and immunizations that may be available:
For babies born to mothers with hepatitis B, waiting for the first dose of the pentavalent vaccine is too late and will NOT protect the baby from vertical or horizontal transmission of hepatitis B. Babies born to a mother with hepatitis B have a greater than 90% chance of developing chronic hepatitis B if they are not properly treated at birth.
WHO recommends the hepatitis B vaccine within 24 hours of birth for ALL babies. Plan ahead and inquire about the availability and cost of the monovalent , birth dose of the vaccine, as it is not a GAVI provided immunization. This is particularly important to women who are positive for hepatitis B.
If you are unsure of your hepatitis B status, please be sure your doctor tests you for hepatitis B!
*WHO does not recommend a birth dose of HBIG, which may not be available in all countries. Talk to your doctor if you have questions.
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