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How Many Hepatitis B Shots Do You Need

Who Should Receive The Hepatitis B Vaccine

What you need to know about Hepatitis B

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

Who Should Get Hepatitis B Vaccine

All infants should get their first dose of hepatitis B vaccine within 24 hours of birth and will usually complete the series at 6 months of age.

All unvaccinated children and adolescents younger than 19 years of age should also get vaccinated.

All adults 19 through 59 years of age are recommended to get vaccinated.

Adults 60 years and older with risk factors should get vaccinated. Risk factors include:

  • People whose sex partners have hepatitis B
  • People who live with someone with hepatitis B
  • Sexually active people who are not in a long-term relationship
  • People getting evaluated or treated for a sexually transmitted infection
  • Men who have sex with men
  • People who share needles, syringes, or other drug-injection equipment
  • Health care and public safety workers at risk for exposure to blood or body fluids
  • People with chronic liver disease, who are on dialysis, have HIV infection, or hepatitis C infection
  • People with diabetes
  • Developmentally disabled persons in long-term care facilities
  • People in prison or jail
  • Travelers to areas with high rates of hepatitis B
  • Anyone who wants to be protected from hepatitis B
  • Vaccines For Hepatitis A And B

    Our immune system battles foreign invaders every day, such as when we get a cold virus. When this happens, we develop immunity to that specific virus. This means that our body will fight off the virus if it is ever exposed to it again.

    The same protection happens with vaccines. However, the benefit of a vaccination is that you don’t have to go through being sick to enable your body to fight off disease.

    Gregory Poland, MD, director of the Mayo Clinic’s Vaccine Research Group, explains that hepatitis vaccinations contain a small amount of the inactive virus. When you get a dose of the vaccine, he says, your immune cells respond by developing immunity against the virus. This immunity lasts over a long period of time.

    “So if I get these two doses of hepatitis A vaccine, and then I get exposed 30 years from now, my body will remember that immunity to the vaccine and rapidly start producing antibodies again,” says Poland.

    Due to the way hepatitis vaccinations are developed, it is impossible to contract the virus from the vaccine itself, according to Poland.

    The hepatitis A vaccine is usually given in two shots and the hepatitis B vaccine is administered as a series of three shots. The most common side effects are redness, pain, and tenderness where the shots are given.

    To get long-term protection from these viruses, it’s important to receive all the shots as scheduled. However, if you received one shot and never went back for the others, it’s not too late to catch up.

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    Hepatitis A And Hepatitis B Vaccine Dosing Information

    Usual Adult Dose for Hepatitis B Prophylaxis:

    Primary immunization: 1 mL IM in the deltoid area at 0, 1 and 6 months.Alternatively, a 4 dose schedule given on days 0, 7, and 21 to 30 followed by a booster at month 12 may be used.

    Usual Adult Dose for Hepatitis A Prophylaxis:

    Primary immunization: 1 mL IM in the deltoid area at 0, 1 and 6 months.Alternatively, a 4 dose schedule given on days 0, 7, and 21 to 30 followed by a booster at month 12 may be used.

    How Is Hepatitis B Treated

    10 Reasons To Get Vaccinated â National Foundation for Infectious Diseases

    Immunoglobulin, a passive immunisation, can be administered within 12 hours of an at-risk exposure to help prevent HBV infection. Treatment for chronic disease is through the use of antiviral medications and medications containing naturally-occurring proteins. A liver transplant may be necessary in the event of severe liver damage.

    A Hepatitis B vaccination schedule is the best way to prevent infection.

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    What Are The Side Effects

    The most common of the hepatitis B vaccine are mild and include:

    • Sore arm from the shot.

    Prepare for your child’s vaccine visit and learn about how you can:

    • Research vaccines and ready your child before the visit
    • Comfort your child during the appointment
    • Care for your child after the shot

    How Many People Have Hepatitis B

    In the United States, an estimated 880,000 to 1.89 million people are chronically infected with HBV. New cases of HBV infection in the United States had been decreasing until 2012. Since that time, reported cases of acute hepatitis B have been fluctuating around 3,000 cases per year. In 2020, 2,157 cases of acute hepatitis B were reported however, because of low case detection and reporting, the Centers for Disease Control and Prevention estimates that there were 14,000 acute hepatitis B infections. The rate of acute cases of HBV decreased by 32% after 2019 which may be related to the disruptions of the COVID-19 pandemic. For the most recent surveillance data visit CDC Viral Hepatitis Surveillance.

    Globally, HBV is the most common blood-borne infection with an estimated 296 million people infected according to the World Health Organization .

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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.

    British Columbia Specific Information

    Why Are Adults 19 to 59 Recommended to Get the Hepatitis B Vaccine?

    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, visit our Hepatitis page.

    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.

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    Who Should Be Immunised Against Hepatitis B

    Hepatitis B immunisation is recommended and funded for the following groups:

    • all children up to their 18th birthday
    • babies born to mothers with hepatitis B infection
    • people who live in close contact with someone infected with hepatitis B
    • anyone undergoing renal dialysis
    • people who have hepatitis C infection, or who are HIV positive, or who have had a needle stick injury.
    • anyone who has received immunosuppression therapy of at least 28 days or has had solid organ or bone marrow transplant.

    Hepatitis B immunisation is also recommended, but not funded, for:

    • workers who are likely to come into contact with blood products, or who are at increased risk of needlestick injuries, assault, etc.
    • people who change sex partners frequently such as sex workers
    • people who regularly receive blood transfusions such as people with haemophilia
    • current or recent injecting drug users
    • migrants and travellers from or to areas with intermediate or high rates of hepatitis B such as the Asia and Pacific region.

    Who Should Get Hepatitis Vaccinations

    Since the vaccines were first developed, the hepatitis A and B vaccines have become part of the regular childhood immunization schedule. They are not considered a routine adult immunization.

    “When we’re talking about adults, I would say yes, get the vaccine if they fit into one of these risk factors” says Poland. “If they don’t fit into the risk factors, their risk is so low that there’s no compelling reason to do it.”

    People at risk for hepatitis A include:

    • Anyone traveling to or working in areas where hepatitis A is more widespread.
    • People whose work puts them in potential contact with hepatitis A, such as those who work with the hepatitis A virus in research labs
    • People who are treated with clotting-factor concentrates
    • People who have chronic liver disease
    • People who use recreational drugs, injected or not
    • Men who have sex with men

    People at risk for hepatitis B include:

    • Anyone traveling to or working in areas where hepatitis B is more widespread.
    • Health care workers and other people whose job exposes them to human blood
    • People with HIV infection, end-stage kidney disease, or chronic liver disease
    • People who live with someone with hepatitis B
    • People who inject street drugs
    • Sexually active people who have had more than one partner
    • Anyone who has had an STD
    • Men who have sex with men
    • Sex partners of people with hepatitis B

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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.

    The Duration Of Protection And The Need For Booster Doses

    Hepatitis C and Pregnancy: Diagnosis and Treatment

    In vaccine efficacy studies, immunocompetent children and adults who developed anti-HBs concentrations of 10 mIU/mL or higher after vaccination had complete protection against both acute disease and chronic infection for decades , even if subsequently, over time, anti-HBs concentrations declined to less than 10 mIU/mL . Indeed, the protective efficacy of hepatitis B vaccination is related to the induction of anti-HBs antibodies, but it also involves the induction of memory B and T cells. Ongoing surveillance of vaccinees is required to clarify whether hepatitis B vaccination can confer longer, or even lifelong, protection . Based on currently available scientific evidence, different advisory groups do not recommend routine booster doses of hepatitis B vaccine in immunologically competent persons who have received a full primary course, because the majority of previously vaccinated people with an anti-HBs antibody concentration of 10 mIU/mL or less mount an anamnestic response when they receive a booster dose or are exposed to HBV, indicating that they remained protected by memory B and T cells .

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    Hepatitis Vaccine: What You Need To Know

    Hepatitis is an inflammatory liver condition. There are five types of viral hepatitis: A, B, C,D, and E. Most cases are caused by a hepatitis virus. The condition can also be a result of excessive alcohol or drug use or a faulty inflammatory immune response that occurs when the immune system mistakes the liver as a threat to the body and begins to attack it.

    There are two hepatitis vaccines that can help prevent hepatitis A and B infections. A third vaccine, developed for hepatitis E, is only permitted for use in China. This article discusses the types of hepatitis that can be prevented with a vaccine and what you need to know before getting one.

    Verywell / Michela Buttignol

    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.

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    Implementing Strategies For Hepatitis B Vaccination

    When hepatitis B vaccines became available, strategies for HBV control were initially focused on vaccination of high-risk groups . However, high-risk individuals are mostly difficult to reach and are often infected before vaccination . Consequently, coverage of 3 doses of hepatitis B vaccine remained low in most high-risk groups due to low compliance and logistic reasons . In addition, as many as 30% or more people with acute hepatitis B infection do not have identifiable risk factors and are therefore missed by only a high-risk group approach .

    Hence it was clear that an additional global strategy was required as the high-risk strategy made little impact and the global burden of hepatitis B diseases became more and more obvious. Decision makers and health professionals worldwide started to discuss a strategy of universal hepatitis B immunization for a certain age cohort, even in low-endemicity countries. In 1991, the WHOs Global Advisory Group of the Expanded Programme on Immunization recommended that hepatitis B vaccine be integrated into national immunization programs in all countries by 1997 . This 1991 recommendation was endorsed by the World Health Assembly in 1992 . Progressively, it has become more widely used and recommendations for HBV vaccination have been extended in an attempt to achieve maximum protection .

    Us Infant Hepatitis B Vaccine Schedules

    Why Do Babies Get So Many Vaccines?
    *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 Infants

    Since 1991, ALL medically stable infants with a birth weight of at least 2,000 g in the U.S. are recommended to receive the first dose of hepatitis B vaccine within 24 hours of birth. The additional 2 doses are given at 1 month and 6 months of age.

    4-Dose Vaccine Combination Series for Infants

    Combination vaccines, such as the pentavalent and hexavalent vaccines, include protection against 5 or 6 diseases, including hepatitis B. The first shot is usually given at 6 weeks of age, but in order to protect infants from hepatitis B beginning at birth, a monovalent or single dose of the hepatitis B vaccine is also recommended within 24 hours of birth. The hepatitis B vaccine series can then be completed with the pentavalent or hexavalent vaccine with the recommended schedule.

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    How Do You Catch Hepatitis B Virus

    Blood from a person infected with hepatitis B virus is heavily contaminated with the virus. As a result, contact with blood is the most likely way to catch hepatitis B. Even casual contact with the blood of someone who is infected can cause infection.

    Healthcare workers are at high risk of catching the disease, as are intravenous drug users and newborns of mothers infected with the virus. Sexual contact can also expose people to infection. The virus is also present in low levels in saliva.

    Hepatitis B Vaccination Schedule For Children And Infants

    The Centers for Disease Control and Prevention recommends that babies and children receive three 0.5 milliliter doses of either Engerix-B or Recombivax HB, starting just after birth.

    The current recommended hepatitis B vaccine schedule for children and infants is as follows:

    Hepatitis B Vaccination Schedule for Infants and Children
    Hepatitis B Vaccine Dose
    3 618 months old

    If your child is undergoing hemodialysis, your healthcare provider may recommend that they receive additional doses of the HBV vaccine.

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    Babies And Children Can Develop Chronic Hbv

    You may be wondering why the recommendations for the HBV vaccine start on the first day of life.

    Adults who contract HBV will likely not experience long-term complications from hepatitis B. But the same is not the case for babies. As many as of babies who contract an HBV infection at birth from their mothers become chronically infected with HBV.

    Children between the ages of 1 and 5 who get an HBV infection have a 25 percent of people who become chronically infected during childhood will develop liver cancer or cirrhosis. Thats why pediatricians want children to have immunity from HBV from the earliest possible age. Many babies and children exposed to HBV receive post-exposure prophylaxis, which decreases chance of infection.

    If youre pregnant, youll most likely have a blood test to see if youre positive for hepatitis B. This allows doctors to find out if theres a chance that you could pass on the virus. These tests are highly sensitive and have a good accuracy rate, but they arent perfect. Additionally, a pregnant person may become infected between the time of the test and giving birth. The first dose of the vaccine given at birth lowers the risk of a newborn baby contracting hepatitis B.

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