Hepatitis B Vaccine
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Hepatitis B Vaccine

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What Is Hepatitis B?

Hepatitis B is a disease caused by the hepatitis B virus (HBV), which attacks the liver. The disease can cause a lifelong infection, cirrhosis of the liver, liver cancer, liver failure, and death.

HBV is spread through the blood of an infected person. It can be spread during sex without a condom, by sharing drugs or needles, through needle sticks or exposure to sharp objects at a jobsite, or from an infected mother to her baby during birth.

It is estimated that 1-in-20 people in the United States will get infected with HBV sometime during his or her life. Certain factors increase the risk of developing hepatitis B, including:

  • Having sex with someone infected with HBV
  • Having multiple sexual partners
  • Injecting illegal drugs
  • Having male homosexual sex
  • Living in the same house as someone with chronic hepatitis B
  • Coming in contact with human blood
  • Working in the home of someone who is developmentally disabled
  • Having hemophilia
  • Traveling to areas where hepatitis B is common
  • Having parents born in Southeast Asia, Africa, the Amazon Basin in South America, the Pacific Islands, or the Middle East

About 30% of people with hepatitis B will not have symptoms. For people who do, symptoms may include:

  • Yellowing of the skin and eyes ( jaundice )
  • Fatigue that lasts for weeks or even months
  • Abdominal pain in the area of the liver (upper right side)
  • Loss of appetite
  • Nausea
  • Vomiting
  • Joint pain
  • Low-grade fever
  • Dark urine and light-colored stool
  • Widespread itching
  • Rash

Symptoms generally occur about 12 weeks after exposure to the virus, but can occur anywhere from 9-21 weeks after exposure. Most hepatitis B infections clear up within 1-2 months without treatment. But when an infection lasts more than six months, it can develop into chronic hepatitis B, which can lead to serious complications, even death.

Chronic hepatitis B can be treated with antiviral drugs.

What Is the Hepatitis B Vaccine?

The hepatitis B vaccine is produced by inserting a gene for HBV into yeast. The yeast is then grown, harvested, and purified. The vaccine is given as an injection into the muscle and should be stored in the refrigerator prior to administration.

Who Should Get Vaccinated and When?

Everyone age 18 and younger and adults over the age of 18 who are at risk should get the hepatitis B vaccine. Adults who are at risk include:

  • People who have had more than one sex partner in six months
  • Men who have sex with other men
  • Sex partners of infected people
  • People who inject illegal drugs
  • Healthcare and public safety workers who might be exposed to HBV-infected blood or body fluids
  • Those living with people with chronic HBV infection
  • Hemodialysis patients

Three doses of the hepatitis B vaccine are given. Newborns receive the first dose before leaving the hospital. If the mother is infected with the virus, the dose is given within 12 hours of birth. The second dose, for all infants, is administered at 1-2 months of age, and the third dose at 6 months of age.

Children and adults who have not been previously vaccinated should have an interval of at least 1 month between the first and second dose. The third dose should be administered at least 2 months after the second. For children aged 11-15 years, there is a 2-dose series available, called Recombivax HB.*

What Are the Risks Associated With the Hepatitis B Vaccine?

All vaccines are capable of causing serious problems, such as a severe allergic reaction.

Most people who get the hepatitis B vaccine do not experience problems. Some may have mild problems, including soreness where the shot was given and mild to moderate fever.

Who Should Not Get Vaccinated?

Anyone who has had a life-threatening allergic reaction to baker's yeast or to a previous dose of hepatitis B vaccine should not get the vaccine. Also, people who are moderately or severely ill should wait until they recover before getting vaccinated.

What Other Ways Can Hepatitis B Be Prevented Besides Vaccination?

Other than getting the hepatitis B vaccine, the best methods of preventing an HBV infection include:

  • Practicing safe sex
  • Getting a blood test for hepatitis B if you are pregnant
  • Avoiding illegal drugs
  • Not using other people's personal care items that may have blood on them (eg, razors, toothbrushes)
  • Considering the risks before getting a tattoo or body piercing
  • Following safety precautions when handling needles or other sharp objects

What Happens in the Event of an Outbreak?

In the event of a hepatitis B outbreak, all susceptible people should be offered the hepatitis B vaccine if they are eligible for it.


National Digestive Diseases Information Clearinghouse

National Immunization Program
Centers for Disease Control and Prevention


Hepatitis B CIB. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/diseases/hepatitis/b/factvax.htm. Accessed February 6, 2007.

Immunization Action Coalition website. Available at: http://www.immunize.org/vis/. Accessed February 6, 2007.

National Center for Infectious Diseases website. Available at: http://www.cdc.gov/ncidod/ .Accessed February 6, 2007.

US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nip. Accessed February 6, 2007.

*Updated Who Should Get Vaccinated and When section on 1/31/2008 according to the following study, as cited by DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm. Updated January 10, 2008. Accessed January 28, 2008.

Last reviewed February 2008 by David Horn, MD, FACP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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