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 .
Emergency Hepatitis B Vaccination
If you have been exposed to the hepatitis B virus and have not been vaccinated before, you should get immediate medical advice, as you may benefit from having the hepatitis B vaccine.
In some situations, you may also need to have an injection of antibodies, called specific hepatitis B immunoglobulin , along with the hepatitis B vaccine.
HBIG should ideally be given within 48 hours, but you can still have it up to a week after exposure.
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.
Page updated September 2022.
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What Are The Symptoms Of Hepatitis B
Some people may exhibit symptoms of acute Hepatitis B, but a majority of the people with chronic Hepatitis B can remain symptom-free for 20-30 years. Serious liver damage can occur in 15-25% of the people with chronic Hepatitis B such as cirrhosis of the liver, liver failure and liver cancer. Some people still may not know they have liver disease caused by Hepatitis B due to lack of symptoms only blood tests for liver function may reveal abnormalities.
Symptoms of acute Hepatitis B virus infection will typically manifest in older children and adults. About 70% of adults and children over the age of 5 with the infection will develop symptoms.
Symptoms of acute Hepatitis B can include:
Typically, symptoms develop an average of 90 days after exposure to the virus, but they can appear anytime between 6 weeks and 6 months after initial exposure.
Symptoms may only last a few weeks, but sometimes can persist for up to 6 months. Many infected with the Hepatitis B virus show no symptoms, but they can still spread the disease.
Visit your doctor if you think you may have Hepatitis B. Since symptoms are often not seen nor experienced, the disease usually needs to be diagnosed via blood tests. Such tests search for the presence of antigens and antibodies to help determine if you have:
- Acute or chronic infection
- An immunity to Hepatitis B
- The potential to benefit from vaccination
How Safe Is The Hepatitis B Vaccine
The hepatitis B vaccine is totally safe for most people. Most babies, kids, and adults have no problems at all when they get the vaccine. In fact, more than 100 million people in the U.S. have gotten the hepatitis B vaccine.
Like all medicines, the hepatitis B vaccine may have some mild side effects: soreness, change in skin color, swelling, or itching around where you get the shot, or a slight fever. But these things arent serious and usually go away pretty quickly. Theres an extremely small risk of having an allergic reaction to the vaccine.
If you get dizzy, feel your heart beating really fast, have a high fever, feel weak, break out in hives, or have trouble breathing, get medical help right away. But again, the risk of having an allergy is super small.
You CANT get hepatitis from the hepatitis vaccine.
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What Is Hepatitis B Vaccine
Hepatitis B is a serious disease caused by a virus. Hepatitis causes inflammation of the liver, vomiting, and jaundice . Hepatitis can lead to liver cancer, cirrhosis, or death.
The hepatitis B adult vaccine is used to help prevent this disease in adults. The dialysis form of this vaccine is for adults receiving dialysis.
This vaccine helps your body develop immunity to hepatitis B, but it will not treat an active infection you already have.
Vaccination with hepatitis B adult vaccine is recommended for all adults who are at risk of getting hepatitis B. Risk factors include: living with someone infected with hepatitis B virus having sexual contact with infected people having hepatitis C, chronicliver disease, kidney disease, diabetes, HIV or AIDS being on dialysis using intravenous drugs living or working in a facility for developmentally disabled people working in healthcare or public safety and being exposed to blood or body fluids living or working in a correctional facility being a victim of sexual abuse or assault and traveling to areas where hepatitis B is common.
Like any vaccine, the hepatitis B vaccine may not provide protection from disease in every person.
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One 2012 study showed that those who slept less than six hours after receiving a Hepatitis B vaccination were less likely to have the appropriate immune response. A similar study showed that inadequate sleep after an influenza vaccine also resulted in an inadequate immune response. Inadequate sleep before vaccination has its risks. Shorter sleep duration two nights before influenza vaccination has been shown to lead to poorer immune response that lasts months afterward.
Time of day for vaccination also influences immunity those who got vaccinated in the morning had greater immunity. One study showed that getting COVID-19 vaccines in the morning led to a stronger immune response than those who received afternoon vaccinations.
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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.
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What Hepatitis B Immunisation Involves
Full protection involves having 3 injections of the hepatitis B vaccine at the recommended intervals.
Babies born to mothers with hepatitis B infection will be given 6 doses of hepatitis B-containing vaccine to ensure long-lasting protection.
If you’re a healthcare worker or you have kidney failure, you’ll have a follow-up appointment to see if you have responded to the vaccine.
If you have been vaccinated by your employer’s occupational health service, you can request a blood test to see if you have responded to the vaccine.
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People With Diabetes Have Twice The Chance Of Becoming Infected With This Liver Disease
by Michelle Crouch, AARP, Updated September 10, 2021
Getty Images
En español | Even though there’s an effective vaccine to prevent it, the Centers for Disease Control and Prevention estimates that about 862,000 Americans are living with chronic, long-term hepatitis B, with the infection causing thousands of of cases of liver failure, cirrhosis and liver cancer ever year.
The virus attacks the liver silently at first, so many people don’t realize they are infected until decades later, when the virus has already done extensive damage or caused liver cancer, says John Scott, M.D., an infectious disease specialist and associate medical director of the Hepatitis and Liver Clinic at Harborview Medical Center in Seattle. It’s a bad cancer, it can be very aggressive, Scott says.
While children are routinely vaccinated against hepatitis B, which can be spread from mother to baby at birth, it’s only recommended for certain groups of adults including diabetics and only 16 percent of Americans age 50 or older have received the vaccine.
Because children are vaccinated, the virus is more commonly spread through sexual contact or by sharing needles, syringes or other drug-injection equipment. The opioid epidemic has caused a spike in the number of cases.
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Do You Need The Hepatitis B Vaccination
If you’re travelling abroad, particularly in sub-Saharan Africa and East Asia, you need to look up the risk of hepatitis B. Vaccination against this virus is recommended for some travellers to high-risk countries.
If you require a vaccination, your pharmacist can provide this as a private service for both a consultation and the vaccination itself. The service is not routinely available on the NHS. Vaccination against hepatitis B involves three or four doses of the vaccine, ideally started at least three months before you travel. There is also a combined hepatitis A and B vaccine.
Research hepatitis B risk in your country of travel
Have a consultation with your pharmacist
Start vaccination 3 months before travel
Continue course of 3 or 4 vaccinations
Take precautions to avoid exposure to hepatitis B
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Learn More About The Condition
Travelling is an exciting adventure but there are a few things to tick off your list before leaving, including your vaccinations. Here we explain everything from signs and symptoms to the vaccinations for hepatitis B.
What is hepatitis B & how do you contract it?
Hepatitis B is a virus that spreads through blood and body fluids causing an infection of the liver.
In the UK, hepatitis B is fairly uncommon but those with a higher risk include people from or travelling to high risk countries, people who inject illicit drugs and people who have unprotected sex with multiple sexual partners.
The virus is present in the blood and body fluid of someone with the infection. Here are the ways it can spread:
From mother to child during pregnancy particularly in countries where the infection is common
Child to child in countries where the infection is common
Having unprotected sex with someone who is infected
Sharing drug equipment such as needles, spoons and filters
Tattoos, body piercings, medical or dental treatment where equipment isnt sterilised
Sharing toothbrushes or razors with someone whos infected
Signs & symptoms
Any symptoms will develop after being exposed to the virus and usually last for two to three months, however hepatitis B symptoms arent always experienced. Its possible for some adults to fight off the virus without them knowing they’ve had it.
Symptoms include: Flu-like symptoms
Loss of appetite
Abdominal pain
Yellowing of skin and eyes
Find And Compare Medicare Part D Plans
Other immunizations covered under Part D include the shingles vaccine , and the Tetanus, diphtheria and pertussis shot. Medicare Part B covers shots to prevent influenza, pneumococcal and COVID-19, as well as hepatitis B.
When you search for Part D Prescription Drug Plans or Medicare Advantage plans that include prescription drug coverage, its a good idea to have a list of your medications handy so you can cross-reference your prescriptions with drugs in the plans formulary. The Part D formulary breaks down approved drugs by tier. Tiers are a way to group drugs according to generic, brand and specialty versions and costs will vary.
TIP: Using an online plan finder that enables you to enter your drug information makes it easier to filter plans that offer the coverage you need.
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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
When Will My Baby Be Immunised
All babies are offered the 6-in-1 vaccine when they’re 8, 12 and 16 weeks old as part of their routine baby vaccines. This vaccine protects against 6 diseases including hepatitis B .
Babies born to mothers who’ve been diagnosed with hepatitis B need extra doses of the vaccine for full protection. In addition to the doses offered to all babies at 8, 12 and 16 weeks, these babies will also be offered extra doses at birth, 4 weeks and 12 months. A blood test at 12 months to check for hepatitis B infection will also be offered.
It’s very important that an eligible baby is given the first dose of the vaccine in the hospital at birth. You’ll be informed by letter where and when you’ll get the additional immunisations. If you’re unsure please contact your midwife, health board or GP.
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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.
Difference Between Hep A And Hep B Vaccines
In the United States, the hep A shot is administered routinely to very young children. It may be given in one or two doses. If the child is getting two doses, the first one should be no later than 12 months of age. There is some flexibility in the interval between shots, but six to 18 months is common.
The hep B vaccine should be given to all babies as soon as possible after birth. After the first dose, two or three doses follow with an interval of at least four weeks. Unvaccinated adults get three doses spanning six months. If you are at least 18 years old, you have the option to get a combination vaccine. The dual vaccine is given in three shots over six months.
Adults traveling to areas with a high rate of HAV would benefit from getting the hep A shot. Talk to your physician about your risk for hep A and hep B to determine if you should receive the vaccines. You can schedule your hepatitis vaccine with your primary care physician or one of your local pharmacies, such as CVS and Walgreens.
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What Are The Symptoms Of Hepatitis A
In some cases, especially in children younger than 6, hepatitis A causes no symptoms. However, infection can cause fever, loss of appetite, nausea, diarrhoea, abdominal pain, and jaundice in others. Elderly people and those with other liver diseases are at risk of developing more serious complications.
What Is The Combined Hepatitis A And B Vaccine
This vaccine protects you from becoming infected with either the hepatitis A and hepatitis B viruses. The adult dose is available to people over the age of 18 and is given as a course of three injections into muscle.
The CDC recommends that the initial dose is followed up with two further injections one and three months later. For the accelerated schedule, the initial dose is followed by two injections one week and three weeks later.
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What Is The Morphology Of Hbv
HBV is an oncogenic DNA virus that belongs to the Hepadnaviridae family. The discovery of the etiologic agent of hepatitis B remains a remarkable scientific achievement. It was discovered in 1965 by Dr Blumberg, who won the Nobel Prize in Medicine for his discovery in 1976 . HBV virus, initially called the Dane particle, is a 42-nm virus . HBV is composed of a nucleocapsid core, surrounded by an outer lipoprotein coat . The virus contains 3 primary structural antigens: surface , core , and e . HBsAg is produced in excess amounts and found in the blood of infected individuals in the form of spherical and tubular particles . These immunogenic, but noninfectious, subviral particles lack genomic DNA and paved the way to develop hepatitis B vaccines . HBV is divided into 4 major phenotypic subtypes based on antigenic epitopes presented on its envelope proteins, and comprises 10 major genotypes that differ at the nucleotide level across full-length genotypes by> 8% . The HBV genotypes have distinct virological characteristics and geographical distributions however, the licensed HBV vaccines are effective against all genotypes .
A, Electron micrograph of hepatitis B virus : Dane particles and spherical and tubular surface antigen particles . Source: Centers for Disease Control and Prevention. As a work of the U.S. federal government. B, A simplified figure of the HBV particle and surface antigens.