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When To Take Hepatitis B Booster Dose

Us Children And Adult Hepatitis B Vaccine Schedules

Hepatitis B Vaccine: Routine and Catch-up Schedule
*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

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 :

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.

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Who Should Get The Hbv Vaccine

The Centers for Disease Control and Prevention recommends that all children and adults up to age 59 should receive the hepatitis B vaccine.

Infants should get their first hepatitis B vaccine within 24 hours of birth and complete their doses by age 6 to 18 months.

All unvaccinated children and adults through age 59 should receive the vaccine. Also, unvaccinated adults over the age 60 who are at risk of hepatitis B should get the vaccine.

Adults over age 60 who are not at risk of hepatitis B may also choose to get the shot.

Several types of the HBV vaccine are also safe to administer to pregnant women.

  • people who have had more than one sex partner in the last 6 months
  • men who have sex with men
  • people seeking treatment for a sexually transmitted infection
  • people whose partners or household members have hepatitis B
  • people who inject drugs
  • people who live or work in care facilities
  • people who are on dialysis
  • travelers to countries where hepatitis B is common
  • people with chronic liver disease, HIV, or hepatitis C
  • people who are in jail or prison

People who have diabetes should talk with a healthcare professional about their risk for contracting hepatitis B.

What Hepatitis B Immunisation Involves

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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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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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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.

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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 Vaccination In Pregnancy

Ending hepatitis B with crucial birth dose vaccine

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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Hepatitis B Vaccine Side Effects

Most people only experience mild, short-term side effects from the hepatitis B vaccine. Common side effects include:

  • Pain, redness, or swelling at the site of injection

Severe allergic reactions to the hepatitis B vaccine are very rare. If you have symptoms of an allergic reaction shortly after getting the HepB vaccinesuch as difficulty breathing, facial swelling, or hivesseek medical help immediately.

The hepatitis B vaccine is safe and effective for most people. However, there are certain people who should not get the HepB vaccine, including:

  • People who are moderately or severely ill at the time of vaccination
  • People who have had a severe allergic reaction to yeast
  • People who have had a severe allergic reaction to a hepatitis B vaccine in the past

When To Delay Or Avoid Hepb Immunization

Doctors delay giving the vaccine to babies who weigh less than 4 pounds, 7 ounces at birth whose mothers do not have the virus in their blood. The baby will get the first dose at 1 month of age or when the baby is discharged from the hospital.

The vaccine is not recommended if your child:

  • is currently sick, although simple colds or other minor illnesses should not prevent immunization
  • had a serious allergic reaction after an earlier dose of the vaccine or is allergic to baker’s yeast

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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.

Transmission Symptoms And Treatment

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How is HBV transmitted?

HBV is transmitted through activities that involve percutaneous or mucosal contact with infectious blood or body fluids , including

  • sex with a partner who has HBV infection
  • injection drug use that involves sharing needles, syringes, or drug-preparation equipment
  • birth to a person who has HBV infection
  • contact with blood from or open sores on a person who has HBV infection
  • exposures to needle sticks or sharp instruments and
  • sharing certain items with a person who has HBV infection that can break the skin or mucous membranes , potentially resulting in exposure to blood.

How long does HBV survive outside the body?

HBV can survive outside the body and remains infectious for at least 7 days .

What should be used to clean environmental surfaces potentially contaminated with HBV?

Any blood spills should be disinfected using a 1:10 dilution of one part household bleach to 9 parts water. Gloves should be worn when cleaning up any blood spills.

Who is at risk for HBV infection?

The following populations are at increased risk for becoming infected with HBV:

  • Infants born to people with HBV infection
  • Sex partners of people with HBV infection
  • Men who have sex with men
  • People who inject drugs
  • Household contacts or sexual partners of known people with chronic HBV infection
  • Health care and public safety workers at risk for occupational exposure to blood or blood-contaminated body fluids
  • Patients on hemodialysis

Who should be screened for HBV?

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Who Should Not Receive The Hepatitis B Vaccine

Talk to your healthcare provider before getting the hepatitis B vaccine if:

  • You have had a severe allergic reaction to the hepatitis B vaccine or any of its ingredients in the past.
  • You have had an allergic reaction to yeast in the past.
  • You are moderately or severely ill.
  • You are currently taking immunosuppressive medications.

In addition, pregnant people should not receive the Heplisav-B or PreHevbrio vaccines until more safety information is available.

How Common Is Hepatitis B

One U.S. study following trends in hepatitis B infection over a three-year periodfound that 4.3% of the population had a past or present HBV infection.

Estimates suggest that about 240 million people around the world have chronic hepatitis B. Up to 1.89 million people in the United States have a chronic HBV infection.

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Many People With Hbv Dont Know They Have It

HBV infections are becoming less common in the United States. But HBV is still widespread in other parts of the world. Around 257 million people living around the world currently have HBV, and many of them dont know it. Chronic HBV is often asymptomatic, and even when it isnt, it can take months for symptoms to show up.

HBV can be transmitted through sexual contact and the use of IV drugs , and other risk factors. Although rare, there

Measurement Of Outcome And Exposures

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The primary endpoint of the current study was the proportion of individuals with seroprotection according to the PVST. First, we assessed the relation between time from the third vaccination to PVST and seroprotection according to the PVST. Time to PVST was categorized in < 1 , 12 , 36 , and 7 months , in part adapted from the recommendations of the ACIP. Secondly, this study assessed whether the interval between the first and second vaccination and between the second and third vaccination were independent predictors of seroprotection in patients with PVST at 12 months. Time between the first and second vaccination was categorized into < 1 , 12 , 34, and 5 months, adapted from ACIP guidelines. Accordingly, the interval between the second and third vaccination was grouped into < 4 , 45 , 611, and 12 months.

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The Hepatitis B Vaccine

The hepatitis B vaccine is used to prevent hepatitis B. Its usually provided in three doses.

The first dose can be taken on a date you choose. The second dose must be taken 1 month later. The third and final dose must be taken 6 months after the first dose.

Some people may need two or four doses of this vaccine.

There is also a newer hepatitis B vaccine thats offered in two doses.

Who Should Not Get The Hepatitis B Vaccine

Hepatitis B is a safe vaccine that does not contain a live virus.

However, there are some circumstances in which doctors advise against getting the HBV vaccine.

You should not receive the hepatitis B vaccine if:

  • youve had a serious allergic reaction to a previous dose of the hepatitis B vaccine
  • you have a history of hypersensitivity to yeast or any other HBV vaccine components

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Dosage And Vaccination Schedule

Dosage varies according to age and type of vaccine used: follow manufacturer’s instructions.

Child: one dose = 5 to 10 micrograms

Adult: one dose = 10 to 20 micrograms

  • Standard schedule
  • Neonate and infant:
  • One dose as soon as possible after birth then a 2nd dose at 6 weeks and a 3rd dose at 14 weeks
  • One dose as soon as possible after birth then 3 doses administered 4 weeks apart with the 1st at 6 weeks, the 2nd at 10 weeks and the 3rd at 14 weeks
  • Child, adolescent, adult: schedule 0-1-6

2 doses 4 weeks apart, then a 3rd dose 6 months after the 1st dose

  • Accelerated schedule, when rapid protection is required in the event of post-exposure prophylaxis

3 doses administered during the same month on D0-D7-D21, then a 4th dose one year after the 1st dose

Babies And Children Can Develop Chronic Hbv

Booster Dose Vaccination for Preventing Hepatitis B : A Meta

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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Us Infant 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 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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