Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. In many countries outside of Canada, HB vaccine is in limited use.
All persons from a country that is endemic for HB should be assessed and vaccinated against HB if not immune and not infected. Individuals born in developing countries are more likely to be carriers of HB, necessitating vaccination of their sexual and household contacts based on review of their serologic test results. HB vaccine is recommended for all household contacts whose families have immigrated to Canada from areas in which there is a high prevalence of HB and who may be exposed to HB carriers through their extended families or when visiting their country of origin.
Children adopted from countries in which there is a high prevalence of HB infection should be screened for HBsAg and, if positive, household or close contacts in the adopting family should be immunized before adoption or as soon as possible thereafter. Adults going to pick-up children from these countries should be vaccinated before departure. Refer to Immunization of Persons New to Canada in Part 3 for additional information.
Why Should I Vaccinate My Newborn Child If I Know That I Am Not Infected With Hepatitis B Virus
Before the hepatitis B vaccine, every year in the United States about 18,000 children were infected with hepatitis B virus by the time they were 10 years old. This statistic is especially important because people are much more likely to develop liver cancer or cirrhosis if they are infected early in life, rather than later in life .
About 9,000 of the 18,000 children infected in the first 10 years of life caught the virus from their mother during birth. However, many young children didn’t catch the disease from their mother. They caught it from either another family member or someone else who came in contact with the child. Because hepatitis B can be transmitted by relatively casual contact with items contaminated with blood of an infected person, and because many people who are infected with hepatitis B virus don’t know that they have it, it is virtually impossible to be “careful enough” to avoid this infection.
For these reasons, all young children are recommended to receive the hepatitis B vaccine. The best time to receive the first dose is right after birth. This will ensure that the child will be protected as early as possible from catching hepatitis B from people who dont know that they are infected with the virus.
Listen to Dr. Offit explain why newborns get the hepatitis B vaccine by watching this short video, part of the series Talking About Vaccines with Dr. Paul Offit.
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 .
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A Look At Each Vaccine: Hepatitis B Vaccine
The hepatitis B vaccine is given to prevent the severe liver disease that can develop when children or adults are infected with hepatitis B virus. The hepatitis B vaccine is given as a series of three shots. The first dose is given within 24 hours of birth. The second dose is given one to two months after the first dose, and the third dose is given between 6 months and 18 months of age.
I Am A Healthcare Worker Who Did Not Develop Hepatitis B Antibodies After Immunization What Should I Do
Not everyone responds to the hepatitis B vaccine. In fact, in a group of adults younger than 40 years of age who have received two doses of the vaccine only 75 of 100 will be protected. Following the third dose, this number will increase to 90 of 100. However, people older than 40 years of age will be less likely to respond to the vaccine with increasing age.
Even if people do not respond to three doses, it does not mean that they are at high risk for hepatitis B. Because hepatitis B is transmitted primarily through blood and body fluids, using safety precautions while working will help decrease the chance of exposure to the disease. It is also possible that the immune response was not great enough to be measured by the laboratory test, but would still provide some level of protection upon exposure to hepatitis B. The CDC recommends getting the three-dose series again if an immune response is not generated following the first series.
About 5-10 of every 100 children and adults younger than 40 years of age do not respond to the third dose of the hepatitis B vaccine. Some of these people will be recommended to get the series of three doses again. About 5 of 100 people will still not respond after six doses. If these people are determined not to have chronic hepatitis B, they will be reliant on taking precautions to reduce the chance of exposure and relying on those around them for protection. In other words, these people will be reliant on herd immunity.
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Talk With Your Health Care Provider
Tell your vaccination provider if the person getting the vaccine:
Has had an allergic reaction after a previous dose of hepatitis B vaccine, or has any severe, life-threatening allergies
In some cases, your health care provider may decide to postpone hepatitis B vaccination until a future visit.
Pregnant or breastfeeding people should be vaccinated if they are at risk for getting hepatitis B. Pregnancy or breastfeeding are not reasons to avoid hepatitis B vaccination.
People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting hepatitis B vaccine.
Your health care provider can give you more information.
More Information On Side Effects
Reactions listed under âpossible side effectsâ or âadverse eventsâ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.
If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency through the Yellow Card Scheme
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British Columbia Specific Information
Hepatitis B is a virus that attacks the liver. It can cause serious disease, including permanent liver damage , and is also the main cause of liver cancer.
The hepatitis B vaccine provides immunity for at least 10 years and likely for a lifetime when completing the full series. There are currently no recommendations for a healthy person to receive a booster for this vaccine if they have completed the full series.
For more information on hepatitis B and the hepatitis B vaccine, see:
You may also call 8-1-1 to speak to a registered nurse or pharmacist. Our nurses are available 24 hours a day, 7 days a week and our pharmacists are available every night from 5:00 p.m. to 9:00 a.m.
tetanus, diphtheria, pertussis, polio, Haemophilus influenzae type b, and hepatitis B combined vaccine
Hepatitis B Vaccine Information For Health Professionals
Hepatitis B vaccination is recommended for all infants, children, and adolescents. Don’t miss opportunities to vaccinate your patients who didn’t receive hepatitis B vaccine as infants.
You don’t need to restart a series of hepatitis B vaccinations because of an extended interval between doses. It is not necessary to add doses or restart the series if the interval between doses is longer than that which is recommended.
There are over 200 million hepatitis B carriers worldwide , and the disease causes up to 80 percent of liver cancers. Chronic hepatitis B is second only to tobacco among known human carcinogens.
More than 250,000 people die each year around the world of hepatitis B-associated acute and chronic liver disease.
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Managing Fever After Immunisation
Common side effects following immunisation are usually mild and temporary . Specific treatment is not usually required.
There are a number of treatment options that can reduce the side effects of the vaccine such as giving extra fluids to drink and not overdressing if there is a fever.
Although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given check the label for the correct dose or speak with your pharmacist, especially when giving paracetamol to children.
What Should I Do If I Am Exposed To The Hepatitis B Virus
If you know you were recently exposed to the hepatitis B virus, you may get protection from an injection of hepatitis B immunoglobulin , which is different from the hepatitis B vaccine.
HBIG is given only when it is suspected or known that someone has been infected with hepatitis B, and it is given within 24 hours after the exposure.Unlike the vaccine, which is not given after exposure, HBIG is given before a potential exposure. HBIG will protect you for 3 to 6 months, but it is strongly recommended that you also begin the 3-shot hepatitis B vaccination series within 7 days of your exposure.
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Information Sheets For The Population
Information sheets for the population
Diphtheria, pertussis, tetanus, hepatitis B, poliomyelitis, Hæmophilus influenzæ type b
Measles, mumps, rubella and varicella
This publication is available only in an electronic version.
This publication is available in French.
Rare Side Effects After Immunisation
There is a very small risk of a serious allergic reaction to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation, in case further treatment is required.
If you think your child may be having a serious allergic reaction and you are no longer at the clinic where they were immunised, take them immediately to your doctor or to the nearest hospital, or call 000 for an ambulance.
Another rare side effect is the hypotonic-hyporesponsive episode . If they are experiencing HHE, a baby may be:
This may occur from one to 48 hours following vaccination. The whole episode may last from a few minutes to 36 hours.
If you think your child may be having an HHE episode, take them immediately to your doctor or to the nearest hospital.
Follow-up of children with HHE shows no long-term neurological or other side effects.
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Concurrent Administration Of Vaccines
HB-containing vaccines may be administered concomitantly with other vaccines or with HBIg. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections.
Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
Facts About Hepatitis B
- Two billion people, or one in three, have been infected with hepatitis B worldwide. Of these, about 260 million live with chronic hepatitis B.
- 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 minute 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 is the fourth leading cause of cancer deaths throughout the world, behind lung, colorectal and stomach cancers.
- 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 2017, about 8 of 10 infants born throughout the world received three doses of hepatitis B vaccine.
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Hepatitis B Vaccine On The Nhs
A hepatitis B-containing vaccine is provided for all babies born in the UK on or after 1 August 2017. This is given as part of the 6-in-1 vaccine.
Hospitals, GP surgeries and sexual health or GUM clinics usually provide the hepatitis B vaccination free of charge for anyone at risk of infection.
GPs are not obliged to provide the hepatitis B vaccine on the NHS if you’re not thought to be at risk.
GPs may charge for the hepatitis B vaccine if you want it as a travel vaccine, or they may refer you to a travel clinic for a private vaccination. The current cost of the vaccine is around £50 a dose.
What Is Hepatitis B Virus
Hepatitis B virus attacks the liver. Hepatitis B virus infections are known as the “silent epidemic” because many infected people don’t experience symptoms until decades later when they develop hepatitis , cirrhosis , or cancer of the liver . Every year in the United States about 22,000 new hepatitis B infections occur and about 2,000 people die from their infections.
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You Can Have It And Not Know It
What is hepatitis B?
Hepatitis B is a liver disease caused by the hepatitis B virus . HBV is far more infectious than HIV and can be prevented by a vaccine. People who have not been vaccinated may be at risk of getting infected.
About 95 percent of adults will recover within 6 months of becoming infected and as a result will develop lifelong protection against it. The remaining 5 percent are unable to clear the virus and will become chronically infected. Chronic hepatitis B infection is treatable.
It is estimated that less than 1 percent of Canada’s population is infected with either acute or chronic HBV. People who are infected before the age of 7 are at a higher risk of developing chronic infection. In 2011, the overall reported rate of acute hepatitis B infection in Canada was 0.6 reported cases per 100,000 people living in Canada.
Why is hepatitis B a health concern?
Many people infected with HBV do not know they have the virus because symptoms can take two to six months to appear and only about 50 percent of people develop symptoms. During this time, they can spread the infection to others. You may not know you have this infection until damage has already been done to your liver. Potential complications from chronic HBV infection include cirrhosis of the liver, liver failure, liver cancer and premature death.
Why do I need my liver?
How is hepatitis B spread?
HBV is spread through contact with infected blood and body fluids including semen and vaginal fluid.
Is It Okay To Get An Extra Dose Of Hepatitis B Vaccine
Yes. Although extra doses of vaccine are not recommended, you can think of the extra dose as another chance for the immune system to see the hepatitis B virus. A vaccine is not the only time the immune system will see the virus or bacteria contained in it. People may be exposed to the virus or bacteria at school or the store or when visiting family or friends. An extra dose of vaccine is like one more exposure, except the difference is that the virus or bacteria in any vaccine has been made safe, so it wont make you ill.
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Persons With Inadequate Immunization Records
Evidence of long term protection against HB has only been demonstrated in individuals who have been vaccinated according to a recommended immunization schedule. Independent of their anti-HBs titres, children and adults lacking adequate documentation of immunization should be considered susceptible and started on an immunization schedule appropriate for their age and risk factors. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information.
Immunisation Against Hepatitis B For People At Risk
In Victoria free hepatitis B vaccine is provided for people who are at increased risk, including:
- Men who have sex with men.
- People living with HIV.
- People living with hepatitis C.
- People no longer in a custodial setting who commenced, but did not complete, a free vaccine course while in custody.
- Aboriginal and Torres Strait Islander people.
- People born in priority hepatitis B endemic countries who arrived in Australia in the last 10 years priority countries include China, Philippines, Malaysia, Vietnam, Afghanistan, Thailand, South Korea, Myanmar , Indonesia, Singapore, Hong Kong, Taiwan and Cambodia.
- Vulnerable citizens people who have experienced hardship that prevented them from accessing the vaccine earlier. Vulnerable citizens are vaccinated based on an individual assessment by an immunisation provider.
Immunisation is also recommended, but not free, for people who are at increased risk including:
If you think you have been exposed to hepatitis B, see a doctor immediately. Your doctor can give you treatment that, in some instances, can greatly reduce your risk of infection with hepatitis B.
Remember that being immunised against hepatitis B does not protect you against HIV, hepatitis C or other diseases spread by blood or bodily fluids. It is important that you take precautions to make sure you are not exposed to these diseases.
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How Is The Hepatitis B Vaccine Given
The hepatitis B vaccine is a “recombinant vaccine,” which means that it is a fragment of the hepatitis B virus that has been produced in a laboratory. The vaccination for hepatitis B is given as 3 injections over a 6-month period – an initial dose, followed by a second dose 1 month later, and a third dose 5months after the second.
If you need hepatitis A vaccination in addition to hepatitis B, you can do these individually or as a combined vaccine that covers both. The combination vaccine is given as 3 injections over a 6-month period – an initial dose, followed by a second dose 1 month later, and a third dose 5 months after the second.
If you are not able to get the shots on time, it is not necessary to restart the series, but you should continue from the last dose given.
You will NOT get hepatitis B from the vaccine.
You will be protected for about 13 years. If it has been many years since you received your hepatitis B vaccination, or if you do not know when you were vaccinated, ask your doctor to check to see if you have antibodies against hepatitis B.