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.
Interchangeability Of Hepatitis B Vaccines
The Engerix-B and H-B-Vax II vaccines are manufactured by different processes, and the hepatitis B surface antigen content of an equivalent dose of these vaccines is different. Switching vaccine brands is not recommended.
If the brand of vaccine used for previous doses is not known, use another age-appropriate equivalent dose brand. See:
For example, a study in healthy neonates showed comparable high levels of immunogenicity between 2 different mixed regimens that used 2 monovalent hepatitis B vaccines from different manufacturers.33
Accelerated 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.
In some instances, it may be necessary to vaccinate within a short period of time to ensure protection before travel. There are accelerated schedules to provide the highest level of protection over a short period of time. Individuals who need an accelerated schedule must have a booster dose at 1 year to ensure long-term protection. Note that the 2-dose Heplisav-B vaccine will also ensure maximum protection over a 1-month period without the need for a booster dose at 1 year.
4-Dose Vaccine Series for Children and Adults
Engerix-B is a 3-dose vaccine that can be given on an accelerated, four-dose schedule, with 3 shots administered within 2 months, and a booster dose at 1 year to provide maximum long-term protection.
4-Dose Combination Hepatitis A and B Vaccine Series
Twinrix is a 4-dose vaccine that can be given on an accelerated schedule to provide protection against hepatitis A and B. Three doses are administered within 1 month, followed by a booster shot at 1 year. This is a common choice of vaccine for those travelling on short-notice outside the U.S. It is important to complete the booster dose at 1 year, to ensure long-term protection.
2-Dose Vaccine Series
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Do The Benefits Of The Hepatitis B Vaccine Outweigh Its Risks
Every year in the United States about 2,000 people die following an overwhelming hepatitis B virus infection. In addition, every year about 22,000 people are infected with hepatitis B. Some of them will remain chronically infected, putting them at high risk of the long-term consequences of hepatitis B virus infection: cirrhosis and liver cancer. In fact, with the exception of influenza virus, hepatitis B virus causes more severe disease and death in the United States than any other vaccine-preventable disease. On the other hand, the hepatitis B vaccine is an extremely rare cause of a severe allergic reaction called anaphylaxis. To date, no one has died from this reaction, but it is theoretically possible that this could occur.
Because hepatitis B virus is a common cause of severe disease and death in the United States, and because the hepatitis B vaccine does not cause permanent damage or death, the benefits of the hepatitis B vaccine clearly outweigh its risks.
Safety Of Hepatitis Vaccines
Hepatitis vaccines have been given to millions of people all across the world without any evidence of serious side effects. “They’re very safe, and they’re extremely effective,” says Poland.
If you are not sure whether you should have hepatitis vaccines, talk with your doctor about your specific concerns.
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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.
Treatment And Manifestation Of Hepatitis A And B
Hepatitis A has an incubation time of two to six weeks. Hepatitis B only manifests after two to six months. Often patients with hepatitis A and B infection have moderate to no signs of the infection.
In persons who show symptoms, they will get flu-like symptoms, which will occur about three to ten days before symptoms of the liver develop.
Thereafter, the urine will darken, and jaundice may grow. With jaundice, the skin and the whites of a person’s eyes have a yellow hue. The inflamed liver cannot conduct its normal biochemical processes, so a material called bilirubin increases in the body.
Typically, you tend to feel healthy when you have jaundice, even though you keep looking worse.
In hepatitis A the jaundice stage only lasts for about one week. After that, you’ll continue to heal and usually feel like your usual self within a month. You are immune for life after recovering from hepatitis A.
In hepatitis B, the jaundice stage is about two weeks.
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Do I Need To Pay For Hepatitis B Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
How Does One Administer Twinrix
Twinrix is given by injecting the liquid into the muscles. How many Twinrix shots do I need? It is provided as a sequence of three dosages. With the second dose given at least one month after the first. The final and third dose given at least six months after the first dosage.
A 4-dose rapid schedule is also accessible for individuals 19 years of age and over. It is safe to receive the hepatitis A and B vaccination in conjunction with other vaccines.
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Prevalence Of Chronic Hepatitis B
The prevalence of chronic hepatitis B virus infection varies between and within countries:58-61
- < 0.5% among Caucasians in the United States, northern Europe and Australia
- 15% in Mediterranean countries, parts of eastern Europe, Africa, and Central and South America
- > 10% in many sub-Saharan African, East and Southeast Asian, and Pacific island populations
Regions where 2% of the population is positive to hepatitis B surface antigen are considered to have moderate to high prevalence. In these regions, people mainly acquire the infection perinatally or in early childhood.55
What Is Hepatitis B
Hepatitis B is a highly infectious disease caused by the hepatitis B virus. It affects the liver and exists in two forms acute and chronic. The virus can be transmitted through direct contact with infected blood and other bodily fluids, as well as via sexual intercourse. It can also be transmitted from mother to child during pregnancy and childbirth.
Other ways to contract the virus include intravenous drug use, working in healthcare , tattooing, acupuncture, unprotected sex , and living with an infected individual. People with compromised immune systems and other chronic diseases are also at a higher risk of contracting the virus.
It is important to note that Hepatitis B cant be transmitted via holding hands, kissing, breastfeeding, or eating with the same utensils.
Commonly, the chronic variation of the disease shows no obvious symptoms, though people suffering from it may eventually develop liver cancer and cirrhosis. On the other hand, acute Hepatitis B takes between 30 and 180 days to show the first signs. The most common symptoms include a loss of appetite, fever, weakness, the yellowing of eye whites and skin, dark urine, fatigue, pain in muscles and joints, and abdominal discomfort.
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Babies And Hepatitis B Vaccination
Pregnant women have a routine blood test for hepatitis B as part of their antenatal care.
Babies born to mothers infected with hepatitis B need to be given a dose of the hepatitis B vaccine within 24 hours of their birth, followed by further doses at 4, 8, 12 and 16 weeks of age, plus a final dose when they’re 1 year old.
Babies of mothers identified by the blood test as particularly infectious might also be given an injection of HBIG at birth on top of the hepatitis B vaccination to give them rapid protection against infection.
All babies born to mothers infected with hepatitis B should be tested at 1 year of age to check if they have become infected with the virus.
Who Should Receive Twinrix
According to Canadian medical advice, the vaccine is required for all those seeking to minimize their hepatitis A and B infection risk. Twinrix is used for vaccinating adults, teenagers, youngsters and babies above one year of age.
In specific, vaccination against hepatitis A is suggested for:
- Travellers to countries or areas with a risk for hepatitis A
- The Canadian armed forces, emergency organization, or any other organization likely to be sent at short notice to high-risk areas for hepatitis A
- Zoo workers, veterinarians, and researchers
- People diagnosed with liver disease
- Hemophiliacs
Hepatitis B vaccination is prescribed for those who:
- Travellers to countries or areas with a risk for hepatitis B
- Nurses, including medical students
- People in contact with someone with hepatitis B
- People who use medication through injections
- Hemophiliacs
- Immigrants and students coming to Canada
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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.
Does The Hepatitis B Vaccine Have Side Effects
Some children will develop pain or soreness in the local area of the shot, and low-grade fever.
There is one extremely rare, but serious, side effect. About 1 out of every 600,000 doses of the hepatitis B vaccine will cause a severe allergic reaction, called anaphylaxis, with symptoms including swelling of the mouth, difficulty breathing, low blood pressure or shock. Anaphylaxis usually occurs within 15 minutes of receiving the vaccine. Although anaphylaxis can be treated, it is quite frightening. People should remain at the doctors office for about 15 minutes after getting the vaccine.
Although the hepatitis B vaccine is made in yeast cells, no one has ever been shown to be allergic to the yeast proteins contained in the hepatitis B vaccine .
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Common And Local Adverse Events
HB vaccine
HB vaccine is well tolerated. Reactions are generally mild and transient, and include: irritability, headache, fatigue and injection site reactions in 10% or more of recipients.
HAHB vaccine
There is no increase in adverse events when HAHB vaccine is compared with HA vaccine given alone or concomitantly with HB vaccine at a different injection site. When the adult formulation of HAHB vaccine is given to children in the 2 dose schedule, there is no increase in adverse events compared with those occurring after administration of the pediatric formulation of HAHB vaccine.
DTaP-HB-IPV-Hib vaccine
Reactions are usually mild and transient, and include fever, irritability, restlessness and injection site reactions .
HBIg
Headache, diarrhea, fever, urticaria, angioedema and injection site reactions may occur.
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.
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Side Effects Of Hepatitis B Vaccines
Immunisations containing components to protect against hepatitis B are effective and safe, although all medication can have unwanted side effects.
Side effects from the vaccine are uncommon and usually mild, but may include:
- Localised pain, redness and swelling at the injection site.
- Low-grade temperature .
- In children being unsettled, irritable, tearful, generally unhappy, drowsy and tired.
- Occasionally, an injection-site lump that may last many weeks, but for which treatment is not needed.
Who Should Have The Hepatitis A Vaccine
People usually advised to have the hepatitis A vaccine include:
- close contacts of someone with hepatitis A
- people planning to travel to or live in parts of the world where hepatitis A is widespread, particularly if sanitation and food hygiene are expected to be poor
- people with any type of long-term liver disease
- men who have sex with other men
- people who inject illegal drugs
- people who may be exposed to hepatitis A through their job this includes sewage workers, people who work for organisations where levels of personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas
Contact your GP surgery if you think you should have the hepatitis A vaccine or you’re not sure whether you need it.
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Aboriginal And Torres Strait Islander People
Aboriginal and Torres Strait Islander people are recommended to:
- have their risks and vaccination status for hepatitis B reviewed
- receive testing for previous hepatitis B virus infection
- receive vaccination if non-immune
Aboriginal and Torres Strait Islander people have a higher risk of acquiring new hepatitis B virus infection than non-Indigenous Australians.2,3
Adult-formulation hepatitis B vaccine should be given in a 3-dose schedule.
Children with HIV are recommended to receive 3 doses of hepatitis B vaccine using an adult formulation. This is double the recommended dose for children. In a limited number of studies, children who were immunocompromised responded better when given higher doses in a 3-dose schedule.4,5
Levels of antibody to hepatitis B surface antigen should be checked after the vaccination course. See Serological testing after hepatitis B vaccination.
Adults with HIV are recommended to receive larger-than-usual doses of hepatitis B vaccine. They should receive 2 injections of the standard adult dose on each occasion at 0, 1, 2 and 6 months. Limited studies in adults with HIV have revealed an improved and accelerated serological response to a schedule that consists of 4 double doses.6,7
A 3-dose schedule at 6, 8 and 12 months after transplant is required using:
Incidence Of Acute Hepatitis B In Australia
Newly acquired cases of hepatitis B virus infection in Australia mostly occur in young adults, through:65
- injecting drug use
- skin penetration procedures
- sexual contact
Between 2006 and 2015, the notification rate of newly acquired hepatitis B in Australia declined from 1.4 to 0.6 per 100,000 population.64
Since 2001, the rate of diagnosis of newly acquired infections has declined substantially among people aged < 29 years. The decline has been less among people aged 30 years.64,66,67 However, some new hepatitis B virus infections are asymptomatic and may go undetected.
Similar to chronic infection, the incidence of, and hospitalisation rates due to, acute hepatitis B are higher among Aboriginal and Torres Strait Islander people than the general Australian population.64
Hepatitis B vaccines are prepared using recombinant technology. After purification, the hepatitis B surface antigen protein is adsorbed onto elemental aluminium . Hepatitis B vaccines may contain up to 1% yeast proteins (but no yeast DNA
The Engerix-B and H-B-Vax II vaccines are manufactured by different processes, and the HBsAg content of equivalent doses of these 2 vaccines is different. The HBsAg content of the paediatric formulations of these 2 vaccines is half that of the corresponding manufacturers adult formulation.
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Persons With Chronic Diseases
Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional general information about vaccination of people with chronic diseases.
Chronic renal disease and patients on dialysis
People with chronic renal disease may respond sub-optimally to HB vaccine and experience more rapid decline of anti-HBs titres, and are therefore recommended immunization with a higher vaccine dose. Individuals undergoing chronic dialysis are also at increased risk for HB infection. In people with chronic renal disease anti-HBs titre should be evaluated annually and booster doses using a higher vaccine dose should be given as necessary.
Neurologic disorders
People with conditions such as autism spectrum disorders or demyelinating disorders should receive all routinely recommended immunizations, including HB-containing vaccine.
Chronic liver disease
HB immunization is recommended for non-immune persons with chronic liver disease, including those infected with hepatitis C, because they are at risk of more severe disease if infection occurs. Vaccination should be completed early in the course of the disease, as the immune response to vaccine is suboptimal in advanced liver disease. Post-immunization serologic testing may be used to confirm vaccine response.
Non-malignant hematologic disorders
Persons with bleeding disorders and other people receiving repeated infusions of blood or blood products are considered to be at higher risk of contracting HB and should be offered HB vaccine.