Vaccinations: Hepatitis B

What is hepatitis B? 

Hepatitis B (HepB) is a serious liver disease caused by the hepatitis B virus (HBV). It's spread when a person comes in contact with blood or other body fluids from a person infected with the hepatitis B virus. Babies born to mothers with hepatitis B can be infected during childbirth. This disease can cause mild illness lasting a few weeks, or it can lead to a serious, lifelong illness.

Acute hepatitis B infection is a short-term illness and occurs within the first 6 months after someone is exposed to the hepatitis B virus. Symptoms can include:

  • fever
  • fatigue
  • nausea and/or vomiting
  • loss of appetite
  • body and/or stomach pain
  • jaundice (yellow skin or eyes, clay-colored bowel movements, dark urine)

Chronic hepatitis B infection is a long-term illness and occurs when the hepatitis B virus remains in a person's body. Most people who develop chronic hepatitis B don't have symptoms but can still spread the hepatitis B virus to others and are at risk for:

  • liver damage
  • liver cancer
  • death

While the majority of infected adults display symptoms, children seldom show signs of the disease. About 90 percent of infants who get hepatitis B become chronically infected and about 1 out of 4 of them dies. There is no cure for hepatitis B but a vaccine can prevent the disease.

Why should I vaccinate my child? 

The hepatitis B vaccine is part of the routine childhood immunization schedule because it protects children from the hepatitis B virus, and the potential liver disease and cancer it may cause. It also protects others from hepatitis B since children sometimes have no symptoms but can still pass on the virus. 

The number of new hepatitis B cases has decreased by more than 90% since the introduction of hepatitis B immunization in 1982. Despite this progress, about 43,000 people become infected annually and about 3,000 deaths per year are associated with viral hepatitis.

How many doses will my child receive? 

The hepatitis B vaccine is typically given as a series of three or four shots (injections).

When is the vaccine given? 

The Centers for Disease Control and Prevention (CDC) recommends that infants get their first dose of the hepatitis B vaccine at birth and should complete the series of 3-4 shots by 6-18 months of age. 

For preterm infants (weighing less than 2,000 grams at birth) born to hepatitis B negative mothers, the CDC recommends administering the first does of hepatitis B vaccine 1 month after birth or at hospital discharge.

Babies born to mothers infected with hepatitis B are given the hepatitis B vaccine and hepatitis B immunoglobulin at birth. A second dose of the vaccine is given at 1–2 months of age, and a third dose at 6 months of age. If they are not responsive to the initial three-dose series, infants born to mothers with hepatitis B can then receive an additional dose of vaccine, and follow-up testing. 

What are the possible side effects? 

Side effects of the vaccine include soreness at the injection site (reported in up to one in four children) and a mild fever (reported in up to one in 15 children). Parents are advised to apply a cool, wet washcloth to the sore area and give acetaminophen or ibuprofen (as directed by the child’s health care provider) for pain and fever. If symptoms persist, parents should contact their child’s health care provider right away.

When should I call a doctor? 

The CDC estimates that severe allergic reactions occur in 1 out of every 1.1 million doses of the hepatitis B vaccine. Parents should immediately alert their child’s health care provider if the child experiences difficulty breathing, wheezing, hives, paleness, or swelling of the face, throat, tongue, lips, eyes, or feet. Such side effects would likely occur within a few minutes to a few hours of receiving the vaccination. Parents should also contact their child’s health care provider if the child has a high fever or displays unusual behavior.

Last updated February 10, 2020

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