Hepatitis B vaccine

Examples

Generic Name	Brand Name
recombinant hepatitis B vaccine	Engerix-B, Recombinvax HB

How It Works

The hepatitis B vaccine is given to protect people from getting the infection. In response to the vaccine, the body develops antibodies against hepatitis B virus (HBV). This response is known as active immunity.

The hepatitis B vaccine is given as a series of three shots (injection) in the upper arm or leg to provide long-lasting immunity.

• The time between the first and second shot should be at least 1 month.
• The time between the second and third shots should be at least 2 months; ideally, it should be 4 months or more.
• At least 4 months should go by between the first and third shots.

If the vaccination series is interrupted and the spacing between doses is longer than recommended, it is not necessary to start the series over or add more doses. The series should be completed from where it was interrupted.

A two-dose series is available for teens ages 11 to 15. The time between the first and second shot should be at least 4 months.

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 (NACI) 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.

For babies

Healthy babies who weigh at least 2000 g (4.4 lb) receive their first dose of hepatitis B vaccine at birth either before going home or within 12 hours of birth if the mother has hepatitis B. When a baby receives the first dose varies by each province and territory.

Babies who are born early (premature) or who weigh less than 2000 g (4.4 lb) usually get their first hepatitis B shot when they are 1 month old if the mother is not infected with hepatitis B.¹

When the other 2 hepatitis B shots are given to babies depends on whether the mother has hepatitis B. Some babies will also need hepatitis B immune globulin (HBIG).

• If the mother is not infected with hepatitis B at the time of birth: Her baby should get the first shot before leaving the hospital, the second at 1 month of age, and the third at 6 months.
• If the mother is infected with hepatitis B at the time of birth: Her baby should get hepatitis B immune globulin (HBIG) within 12 hours of birth and the hepatitis B vaccine at birth. The second shot with the hepatitis B vaccine is given at 1 to 2 months of age, and the third shot at 6 months.
• If it's not known whether the mother has hepatitis B: The mother is tested.
  • If she tests positive for hepatitis B, her baby needs to be given hepatitis B immune globulin (HBIG) no later than 1 week after birth. The next 2 doses of hepatitis B vaccine should be given as stated above for an infant whose mother is infected with hepatitis B at the time of birth.
  • If she tests negative, her baby will not need hepatitis immune globulin (HBIG). The remaining 2 doses of hepatitis B vaccine should be given as stated above for a baby whose mother is not infected with hepatitis B at the time of birth.

For children and teens

Anyone 18 years of age or younger who has not previously received the hepatitis B vaccine should get it. Children adopted from countries where HBV infection is common should be tested for hepatitis B and get shots if they are not immune.

You can keep track of when your child recived vaccines using the national childhood immunization record(What is a PDF document?) or the British Columbia childhood immunization record(What is a PDF document?).

For adults at high risk of exposure

Adults who have not received the hepatitis B vaccine series should be immunized when they have an increased risk of exposure. Job, travel, health condition, or lifestyle all may increase a person's risk of contracting hepatitis B.

People who live or work where there is risk of exposure include:

• Health care and public safety workers who are likely to be exposed to blood or blood products.
• Clients and staff of institutions or residential settings with known or potential HBV carriers.
• People planning extended travel (more than 6 months) to China, Southeast Asia, Africa, and other areas where hepatitis B infection is high.

People who have health conditions that put them at high risk for exposure or a severe infection include:

• People who have a severe kidney disease that requires them to have their blood filtered through a machine (dialysis).
• People who have chronic liver disease.
• People who have hemophilia and other conditions in which they need to have blood products on an ongoing basis.
• People who had a stem cell transplant.

People whose lifestyle puts them at high risk for exposure include:

• People who inject illegal drugs.
• Men who have sex with men.
• People who have had more than one sex partner in the past 6 months or who have a history of sexually transmitted infection.
• Household contacts and sex partners of hepatitis B carriers.
• Prison inmates.

For certain people, such as those with impaired immune systems or who are at high risk of exposure to HBV, health professionals will want to perform a blood test to make sure the vaccine worked (post-vaccination testing).

How Well It Works

Hepatitis B vaccine (Hep B) protects the body from infection for at least 15 years without the need for a booster dose or testing.²

Side Effects

Most people who get the vaccine do not have any problems. But there may be soreness or tenderness where the shot was given or mild fever for a short time.

Even though serious allergic reactions are rare with these medicines, call your doctor or local health unit right away if you or your child has trouble breathing, a high fever, or anything unusual after having the shot.

A child who has had a severe allergic reaction to a previous dose of hepatitis B vaccine should not get another dose of this vaccine. Tell your doctor or nurse if your child has had a severe reaction to any vaccine or has severe allergies.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

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 (HBIG) 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 (immunity) 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 breast-feeding.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Author:	Alison Allen Debby Golonka, MPH	Last Updated: January 29, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics Andrew Swan, MD, CCFP, FCFP - Family Medicine
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