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:
- Fever
- Jaundice
- Joint pain
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
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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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, HA vaccine is in limited use.
HA vaccination should be considered for all persons from HA-endemic countries. Individuals born in HA-endemic countries are more likely to be immune to HA therefore, serologic testing for immunity before HA immunization should be considered. If persons from HA-endemic countries are not immune, they should be offered HA immunization because they are at increased risk for HA exposure through visits to their country of origin, or when receiving friends and family from their country of origin.
In addition, persons new to Canada should be tested for hepatitis C antibody and susceptible persons chronically infected with hepatitis C should be vaccinated against HA and HB. Persons new to Canada should also be tested for HB and vaccinated against HA if found to be a HB carrier. Household or close contacts of children adopted from HA-endemic countries should be immunized with HA-containing vaccine. Adults travelling to pick up adopted children from HA-endemic countries should be vaccinated before departure.
Refer to Immunization of Persons New to Canada in Part 3 for additional information about vaccination of people who are new to Canada.
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About The Hepatitis Vaccine
The hepatitis A and B vaccine is used to prevent infections caused by the hepatitis A and hepatitis B viruses. Hepatitis A is a severe disease that affects the liver and can lead to death, which is why it’s crucial that you get the vaccine. Hepatitis A can be spread by close person-to-person contact and Hepatitis B can be spread through bodily fluids, like semen, blood, saliva, vaginal fluids, or by sharing needles.
The Hepatitis A and hepatitis B combination vaccine are recommended for anyone over the age of 18 who’s at risk of infection from their jobs or certain behaviors. You should also get it if you’re going to be traveling to the Middle East, the Caribbean, Africa, the former Soviet Union, Eastern and Southern Europe, Central and South America, and Southeast Asia .
The Hep A and Hep B combination vaccine is also recommended for people who use illegal injection drugs, people involved in high-risk sexual activity , residents of drug and alcohol treatment centers, military personnel, people who work in a childcare center or correctional facility, and people living in or moving to areas with high rates of HAV infection . It’s also recommended for anyone at risk because of their jobs , as well as people with chronic liver disease or hemophilia.
Do You Need A Hep A Booster
For long-term immunity, the HepA vaccination series should be completed with a second dose at least 6 months after the first dose. However, the second dose is not necessary for PEP. A second dose should not be administered sooner than 6 calendar months after the first dose, regardless of HAV exposure risk.
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Who Should Get The Hepatitis B Vaccine
Most babies now get the HBV vaccine from their doctor as a regular part of their checkups.
Hepatitis B is really contagious. You can easily get it through unprotected sex or contact with infected blood or urine. So if youve never had the vaccine, its a good idea to talk to your doctor about getting it.
Why Vaccination Is Important For Adults
Vaccination isn’t just for children. Vaccines are safe and protect you and those around you from vaccine-preventable diseases.
As we get older, the protection we had from previous vaccination can decrease for some diseases. Getting another dose can increase our immunity to provide the best protection. Some adults may have missed one or more of their vaccines. They may need to catch up and get these vaccines now.
There are also diseases that are more common in adults, even healthy adults. This is why additional vaccines are needed as we get older.
- babies
- people with certain medical conditions, such as those who have weakened immunity
This is known as community immunity or herd immunity.
Check if your vaccines are up to date. Talk to your health care provider to see what you need to be fully protected.
Learn more about:
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Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.
Refer to Reporting Adverse Events Following Immunization in Canada and Vaccine Safety and Pharmacovigilance in Part 2 for additional information about AEFI reporting.
Routine Administration Schedule For Hepatitis B Vaccine In Adults
- The dosing schedule is 0, 1 to 2 months, and 4 to 6 months.
- There is some flexibility in the schedule, but be sure to keep in mind the minimum intervals between doses:
- At least four weeks between doses #1 and #2
- At least eight weeks between doses #2 and #3
- At least 16 weeks between doses #1 and #3
- If your patient falls behind on the hepatitis B vaccination schedule , continue vaccinating from where your patient left off. The series does NOT need to be restarted.
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Hepatitis A And B: Diseases Of The Liver
Hepatitis is an inflammation of the liver, most often caused by a viral infection. There are three common types of hepatitis caused by viruses: hepatitis A, hepatitis B, and hepatitis C. Vaccines have been developed that protect people from contracting hepatitis A and B. There is no vaccine for hepatitis C.
Hepatitis A and hepatitis B can be spread from person to person, although in different ways. They have similar symptoms, which include abdominal pain, fever, fatigue, joint pain, and jaundice .
Over the last 20 years, there has been a 90% decrease in cases of hepatitis A and an 80% decrease in hepatitis B cases in the U.S. Health experts believe that immunization efforts have led to this drop in rates of infection.
Where Does Hepatitis A Occur
Hepatitis A is a very common illness throughout the world. Even developed countries like Canada, the United States or Australia can have outbreaks. But, some regions carry a higher risk of infection.
The vaccine is recommended for travel to almost every region of the world. Some of the most popular destinations where hepatitis A vaccination would be recommended include:
Great experience.
To find out if hepatitis A vaccination is recommended for your trip, see our destination advice portal.
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How Does The Hepatitis B Vaccine Series Work
The vaccine protects you from the hepatitis B virus by getting your body’s immune system to make antibodies. Those antibodies protect you by fighting off the virus if it ever gets into your body.
Usually, the vaccine is spaced out into three different shots called a hepatitis B vaccine schedule. One month after your first shot, you get the second shot. Six months after your first shot, you get the third shot. If you miss your second or third dose, get it as soon as you remember.
The hepatitis vaccine is super effective. Its worked really well to lower the number of people who get hepatitis B every year.
Vaccines For Adults 60 Years Of Age And Older
Some vaccine preventable disease are more common with age, as our immune system may not respond as well as we get older. This puts us at a greater risk for certain diseases, including:
- flu
- pneumococcal disease
The flu is more likely to cause severe illness and even death in older adults.
It’s also important to make sure routine vaccines are up to date for diseases such as:
- diphtheria
- whooping cough
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Hepatitis A Vaccine: Canadian Immunization Guide
For health professionals
Last partial chapter update
: The immunoglobulin dosage for Hepatitis A pre-exposure and post-exposure prophylaxis was increased based on the Product Monograph update for GamaSTAN®, which is available on Health Canada’s Drug Product Database.
Last complete chapter revision: March 2018
Persons With Inadequate Immunization Records
Children and adults lacking adequate documentation of immunization should be considered unimmunized and started on an immunization schedule appropriate for their age and risk factors. HA vaccine may be given, if indicated, regardless of possible previous receipt of the vaccine or pre-existing immunity, because adverse events associated with repeated immunization have not been demonstrated.
Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information about vaccination of people with inadequate immunization records.
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You Can Have It And Not Know It
What is hepatitis B?
Hepatitis B is a liver disease caused by the hepatitis B virus . HBV is far more infectious than HIV and can be prevented by a vaccine. People who have not been vaccinated may be at risk of getting infected.
About 95 percent of adults will recover within 6 months of becoming infected and as a result will develop lifelong protection against it. The remaining 5 percent are unable to clear the virus and will become chronically infected. Chronic hepatitis B infection is treatable.
It is estimated that less than 1 percent of Canada’s population is infected with either acute or chronic HBV. People who are infected before the age of 7 are at a higher risk of developing chronic infection. In 2011, the overall reported rate of acute hepatitis B infection in Canada was 0.6 reported cases per 100,000 people living in Canada.
Why is hepatitis B a health concern?
Many people infected with HBV do not know they have the virus because symptoms can take two to six months to appear and only about 50 percent of people develop symptoms. During this time, they can spread the infection to others. You may not know you have this infection until damage has already been done to your liver. Potential complications from chronic HBV infection include cirrhosis of the liver, liver failure, liver cancer and premature death.
Why do I need my liver?
How is hepatitis B spread?
HBV is spread through contact with infected blood and body fluids including semen and vaginal fluid.
Concurrent Administration Of Vaccines
HA vaccine may be administered concomitantly with other vaccines or with Ig. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections.
If concurrently providing HA-containing vaccine and Ig, separate anatomic injection sites should be used for each injection.
Passive immunization with human Ig preparations can interfere with the immune response to measles-mumps-rubella , measles-mumps-rubella-varicella and univalent varicella vaccines . These vaccines should be given at least 14 days prior to administration of a human Ig preparation, or delayed until the antibodies in the Ig preparation have degraded. Refer to Blood Products, Human Immunoglobulin and Timing of Immunization in Part 1 for additional information.
Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
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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
HA vaccine is recommended for people with chronic renal disease or undergoing dialysis if they are at increased risk of HA infection or severe HA . A study assessing the immune response of hemodialysis patients to standard doses of HA vaccine demonstrated a good HA antibody response and no serious adverse effects.
Chronic liver disease
HA immunization is recommended for susceptible persons with chronic liver disease, including those infected with hepatitis C and chronic HB carriers, 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.
Non-malignant hematologic disorders
Children In Licensed Daycare Centres
If you want your child to attend daycare, and decide not to vaccinate them due to medical, religious or philosophical reasons, you will need to give your daycare a valid written exemption. If the disease appears in your childs daycare centre, your child may have to stay out of daycare until the disease is no longer present.
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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
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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International 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.
The hepatitis B vaccine is an injection that is generally given in the arm and as a three-dose series. The World Health Organization recommends a 0, 1, and 6-month vaccine schedule, though schedules may vary based on a countrys national immunization program. 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. Please note that the vaccine brand name, manufacturer and associated schedules for adults, children and infants may be unique to different countries, though there is a list of WHO prequalified vaccines.
3-Dose Vaccine Series for Infants
The World Health Organization recommends all infants receive the first dose of the hepatitis B vaccine within 24 hours of birth and to complete the vaccine series with additional shots at 1 month and 6 months of age. Beginning the hepatitis B vaccine at birth will ensure protection against hepatitis B for life.
3-Dose Vaccine Series for Children and Adults
4-Dose Combination Vaccine Series for Infants
Additional Resource Links:
Where Can People Get The Hepatitis A Vaccine
Talk to your medical provider about the hepatitis A vaccine. In South Carolina, adults 18 years and older can get vaccinated at some local pharmacies without a prescription, depending on your insurance coverage. To search for a nearby pharmacy that offers vaccines, visit www.vaccinefinder.org.
DHECs local health departments also provide hepatitis A vaccines. DHEC has an Adult Vaccine Program that provides low-cost vaccines for uninsured or underinsured individuals who are 19 years and older.DHECs local health departments are currently providing no-cost hepatitis A vaccines to individuals in at-risk groups .
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