Who Should Get Vaccinated
The Hepatitis B vaccine is typically administered in a sequence of 3-4 shots during a 6-month period.
- Travelers to regions with moderate-to-high rates of Hepatitis B
- People aged 19 59 with diabetes
- Anyone who wishes to be protected from Hepatitis B virus infection
To proactively reach those at risk for Hepatitis B, vaccination is also recommended for people in or seeking treatment from the following:
- Sexually transmitted disease treatment facilities
- HIV testing and treatment facilities
- Health care settings targeting services to men who have sex with men
- Facilities providing drug-abuse treatment and prevention services
- Correctional facilities
- Health care settings targeting services to injection drug users
- Chronic hemodialysis facilities and end-stage renal disease programs
- Institutions and nonresidential day care facilities for developmentally disabled persons
Increased Emphasis On Behavioral Health
Theres a lot coming in terms of mobilizing the behavioral health workforce, Seshamani says.
Medicare will be paying for licensed clinical social workers, psychologists and other behavioral health specialists to be part of a beneficiarys primary care office visit so that they can get their behavioral health services right there, so that the whole person is taken care of, Seshamani says. The program will also improve access to licensed marriage and family therapists.
In addition, Medicare is going to expand its services for substance abuse. We are going to be paying for mobile vans, for example, for opioid treatment to bring care to where people are, Seshamani says.
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
Additional Resource Links:
Read Also: Where Can I Get Tested For Hepatitis C
Why Is The Hepatitis B Vaccine Important
Because of the vaccine, cases of acute hepatitis B have decreased by a lot in the United States. But chronic hepatitis B is still common up to 2.2 million people in the United States have it. Chronic hepatitis B can lead to serious liver problems and even death.
Getting vaccinated is the best way to prevent hepatitis B.
Hepatitis B is a liver disease caused by a virus. There are 2 types of hepatitis B:
- Acute hepatitis B
- Chronic hepatitis B
Many children who get acute hepatitis B dont have any symptoms, but most adults do. Symptoms may include:
- Dark pee or clay-colored poop
- Pain in the muscles, joints, and stomach
Acute hepatitis B symptoms usually last a few weeks but they can last as long as 6 months.
If the acute hepatitis B infection does not go away after 6 months, its considered a chronic hepatitis B infection. Most people who have chronic hepatitis B dont have symptoms at first. But chronic hepatitis B is a lifelong illness that can lead to serious and possibly deadly liver problems, like:
- Has sex with a person who has hepatitis B
- Touches the blood or open sores of a person who has hepatitis B
All children and most adults need to get the hepatitis B vaccine.
Infants and children
All children need to get the hepatitis B vaccine as part of their routine vaccine schedule.
Children need 3 doses of the vaccine at the following ages:
- Birth for the first dose
- 1 through 2 months for the second dose
- 6 through 18 months for the third dose
Adults
Infants Born To Mothers Who Have Hepatitis B: 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.
Protecting Your Baby
Infants born to women with hepatitis B must receive accurate doses of hepatitis B vaccine and hepatitis B immune globulin to ensure complete protection. In order to protect these infants, medications should be given immediately after birth in the delivery room or within the first 12-24 hours of life*.
* See Testing and Treatment During Pregnancy section for details. Please note that testing of all pregnant women for hepatitis B is a global recommendation.
3-Dose Vaccine Series for Infants
The World Health Organization recommends that infants born to hepatitis B positive mothers receive the first dose of the hepatitis B vaccine within 24 hours of birth, and ideally a dose of hepatitis B immunoglobulin . These shots must be followed by the additional vaccine doses given on the recommended schedule. In the U.S., infants should follow a 1 month and 6-month schedule for the additional two doses.
4-Dose Combination Vaccine Series for Infants
Read Also: Is There Any Treatment For Hepatitis B
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
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.
Recommended Reading: What Is Hepatitis C And Is It Curable
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.
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.
Recommended Reading: Hepatitis C Genotype 3 Treatment
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.
Beginnings Of Price Negotiations
By Sept. 1, Medicare will announce the first 10 Part D drugs that under the new law will begin a first-ever process in which Medicare will negotiate prices with drugmakers, Seshamani said, and that will have a huge impact for providing more affordability for drugs for people with Medicare.
Negotiated prices for that first group of drugs, which will be selected from the 50 medicines for which Medicare prescription drug plans spend the most, will take effect in 2026.
Recommended Reading: Hepatitis B Surface Ab Low
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 :
Haemophilus Influenzae Type B
Influenza is a contagious disease that can affect anyone. It affects the respiratory tract in humans, causes an inflammation of the mucous membranes. This includes the nose, throat and lungs.
The infection leads to complications such as lung infections in high-risk groups such as children, the elderly, people with chronic diseases, those with weakened immunities as well as expectant mothers.
Cost: $0 for eligible Singaporean children, or $107 for Infanrix IPV/HIB at Minmed which vaccinates against diphtheria, tetanus, pertussis, poliomyelitis and Haemophilus influenzae type b disease.
You May Like: What Is The Treatment For Hepatitis B And C
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.
Recommended Adult Dosing Volume Of Monovalent Hepatitis B Vaccine
- Age 19 years and younger: Use 0.5 mL per dose .
- Age 20 years and older: 1.0 mL per dose .
For a one-page sheet reviewing the hepatitis B dosing schedule for children and adults, consult IACs Hepatitis A and B Vaccines: Be Sure Your Patients Get the Correct Dose. For complete dosing information, consult the ACIP hepatitis B vaccine recommendations for adults.
Recommended Reading: How Can You Get Infected With Hepatitis B
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.
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.
Recommended Reading: Medication For Hepatitis B Infection
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.
Some Access To Dental Care
Medicare does not cover routine dental care. It does pay for some dental work that is needed in conjunction with another medical procedure, such as pulling a tooth during jaw surgery. Beginning in 2023, the program will expand the type of medically necessary dental services it will cover when needed with other procedures, such as a cleaning or other dental work that will improve the outcome of an organ transplant or cancer treatment.
Recommended Reading: Can You Catch Hepatitis C Sexually
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.
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.
Recommended Reading: Hepatitis B And C Difference
Incidence Rates For Susceptible People With Diagnosed Diabetes And Other Transition Probabilities
The HBV infection rates for people with diagnosed diabetes who are susceptible to infection depend on the incidence of HBV infection among all people with diagnosed diabetes, the prevalence of previous HBV infection, existing vaccine coverage, and the efficacy of prior vaccination. The Supplementary Data describes components of the calculation. Incidence rates for susceptible people with diagnosed diabetes increase from 91 per 100,000 people with diabetes 2024 years of age to a peak of 101 per 100,000 people 3539 years of age, and then decline to 13 per 100,000 people 70 years of age or older . Other disease progression probabilities and epidemiologic parameters are listed in .
Many More Us Adults To Get Vaccinated Against Hepatitis B Following Move By Us Centers For Disease Control And Prevention
The Hepatitis B Foundation and partners are forming an advisory council to promote implementation of theCDCs new universal hepatitis B vaccination recommendations.
Doylestown, Pa., April 1, 2022 The Hepatitis B Foundation enthusiastically endorses the adoption of new adult vaccination guidelines for hepatitis B by the U.S. Centers for Disease Control and Prevention , and the Foundation is organizing a group of experts to help with implementation to ensure millions more U.S. adults get vaccinated against the dangerous virus.
The CDC has adopted formally the landmark recommendations that came last November from its Advisory Committee on Immunization Practices in favor of universal hepatitis B vaccination for all adults ages 19 to 59 in the U.S. The CDC made the announcement in the April 1, 2022, edition of its Morbidity and Mortality Weekly Report .
This is a major step forward that the Hepatitis B Foundation had strongly advocated for over many years, said Chari Cohen, DrPH, MPH, senior vice president of the Foundation. These greatly expanded and simplified recommendations will improve access and make it easier to protect millions more Americans from hepatitis B. This will save countless lives and ultimately reduce health care costs.
Dr. Chari Cohen
Michaela Jackson, MS, MPH, prevention policy manager at the Hepatitis B Foundation, led its advocacy effort for universal vaccination, and she expressed the Foundations great appreciation to the ACIP.
Don’t Miss: Hepatitis B Surface Ab Immunity Qn Low