British Columbia Specific Information
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.
What Is Hepatitis B
Hepatitis B is a serious, potentially fatal liver disease, but there is a vaccine that can prevent it in most people.
Hepatitis B is caused by the Hepatitis B virus . The virus can live outside of the body for 7 days at most, so most people get it directly from touching blood and fluids from people who have the virus. Common ways for the virus to spread include:
- Accidental needle sticks
- Direct contact with blood or open sores of an infected person
- Having sex with an infected person
- Sharing drug equipment
- Sharing razors or toothbrushes with an infected person
Newborn babies are at risk of getting Hepatitis B if their mothers have the virus. Hepatitis B is not spread through food, water, breastfeeding, hugging, coughing or sneezing.
Some people are at a higher risk of getting hepatitis B because of their job, a health condition or where they live. People who have a higher risk should get the vaccine if they have not done so already. Examples of people who have a higher risk of getting hepatitis B are:
- Health care workers
- Infants born to infected mothers
- Recreational injection drug users
- Men who have sex with men
- People on dialysis
- Public safety workers
- Sex partners of people who have the virus
- Travelers to countries with high rates of Hepatitis B virus infection
Who Should Receive The Hepatitis B Vaccine
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
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Who Should Not Get The Vaccine
Speak with your health care provider if you have had a life-threatening reaction to a previous dose of hepatitis B vaccine, or any component of the vaccine such as yeast, or to latex.
There is no need to delay getting immunized because of a cold or other mild illness. However, if you have concerns speak with your health care provider.
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.
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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.
Experimental And Investigational Or Not Medically Necessary
Footnote1*Note: Aetna generally does not cover immunizations required for travel or because of work-related risk. Check contract language, limitations and exclusions for coverage details.
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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.
If I Already Have Hepatitis B Can The Vaccine Treat It
No. The hepatitis vaccine prevents hepatitis, but doesnt cure it if you already have it. If you have hepatitis B, there are other treatment options.
However, if you recently got exposed to the hepatitis B virus and you havent had the vaccine yet, tell your doctor right away. The vaccine and possibly other treatment can reduce your chances of getting hepatitis B if you get it within 2 weeks after you came into contact with the virus. The sooner you seek care after being exposed to hepatitis B, the better, so try to get there right away.
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What To Think About
If you are exposed to HBV before you have received all three shots in the vaccination series, a dose of hepatitis B immune globulin usually will prevent infection until the vaccine takes effect.
If you have already had hepatitis B and have developed protective antibodies to the virus, you do not need the vaccine because you have lifetime protection against the infection. If you are not sure whether you have had hepatitis B, you can be tested, or you can be vaccinated without testing. The vaccine is not harmful for you if you are already immune.
If you have chronic HBV infection, the vaccine will be ineffective, although it is not harmful.
The vaccine is safe for women who are pregnant or breastfeeding.
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.
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Are Hepatitis B Virus Infections Easily Avoided
Large quantities of hepatitis B virus are present in the blood of people with hepatitis B in fact, as many as one billion infectious viruses can be found in a milliliter of blood from an infected individual. Therefore, hepatitis B virus is transmitted in the blood of infected individuals during activities that could result in exposure to blood, such as intravenous drug use, tattooing, or sex with people who are infected. However, it is also possible to catch hepatitis B virus through more casual contact, such as sharing washcloths, toothbrushes or razors. In each of these cases, unseen amounts of blood can contain enough viral particles to cause infection. In addition, because many people who are infected don’t know that they are infected, it is very hard to avoid the chance of getting infected with hepatitis B virus.
Why It Is Used
Hepatitis B virus causes a liver infection that can lead to serious complications, including liver cancer. It is common in people throughout the world, particularly in Asia and sub-Saharan Africa.
The Canadian National Advisory Committee on Immunization recommends hepatitis B immunization for all children. Pregnant women and other adults who do not have immunity and who have a high chance of exposure should be vaccinated.
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Facts About Hepatitis B
- Two billion people, or one in three, have been infected with hepatitis B worldwide. Of these, almost 300 million live with chronic hepatitis B. This means about 1 of every 26 people throughout the world are living with a chronic hepatitis B infection.
- Each year about 900,000 people die from hepatitis B worldwide, and about 2,000 of these deaths occur in the United States.
- Hepatitis B is transmitted through blood and is 100 times more infectious than HIV. An estimated one billion infectious viruses are in one-fifth of a teaspoon of blood of an infected person, so exposure to even a very small amount, such as on a shared toothbrush, can cause infection.
- Hepatitis B is sometimes referred to as the silent epidemic because most people who are infected do not experience any symptoms.
- Liver cancer accounted for about 5% of cancer deaths in the U.S. during 2020.
- Almost half of liver cancers are caused by chronic infection with hepatitis B.
- The World Health Organization recommends the inclusion of hepatitis B vaccine in immunization programs of all countries in 2019, more than 8 of 10 infants born throughout the world received three doses of hepatitis B vaccine.
Does Hepatitis B Go Away
In most cases, hepatitis B goes away on its own. You can relieve your symptoms at home by resting, eating healthy foods, drinking plenty of water, and avoiding alcohol and drugs. Also, find out from your doctor what medicines and herbal products to avoid, because some can make liver damage caused by hepatitis B worse.
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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 Adverse events following immunization in Part 2 for additional information about AEFI reporting.
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
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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.
What Is A Hepatitis B Vaccine
A hepatitis B vaccine prevents hepatitis B virus infection . Engerix-B, Heplisav-B, and Recombivax HB are examples of hepatitis B vaccines approved by the U.S. Food and Drug Administration . Engerix-B and Recombivax HB are both approved for use in people of all ages. Heplisav-B is approved for use in adults 18 years of age and older.HBV can be an opportunistic infection of HIV. An OI is an infection that occurs more frequently or is more severe in people with weakened immune systemssuch as people with HIVthan in people with healthy immune systems. To learn more about OIs, read the HIVinfo What is an Opportunistic Infection? fact sheet. To learn how HIV and HBV infection are connected, read the HIVinfo HIV and Hepatitis B fact sheet.
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What Is Hepatitis B Infection
Hepatitis B is a virus that attacks the liver. It can cause serious disease including permanent liver damage . Hepatitis B is also one of the main causes of liver cancer, which can be fatal. Hepatitis B virus is spread from one infected person to another by contact with blood or body fluids. This includes an accidental or intentional poke with a used needle, being splashed in the mouth, nose, or eyes with infected blood, being bitten by an infected person, sharing items that may have blood on them such as a toothbrush, dental floss or razor, and by having unprotected sex with someone infected with the hepatitis B virus. Mothers who are infected with hepatitis B virus can pass the virus to their newborn babies during delivery.
After the virus enters your body, it usually takes 2 to 3 months to develop symptoms or signs of illness. Symptoms of hepatitis B may include fatigue, fever, nausea and vomiting, loss of appetite, abdominal pain, dark urine, pale stools and jaundice . Many people who get hepatitis B show no symptoms and may not know they have the disease. Whether there are signs of illness or not, you can pass the virus on to others.
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
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