Hepatitis B Vaccination In Pregnancy
Hepatitis B infection in pregnant women may result in severe disease for the mother and chronic infection for the baby.
This is why the hepatitis B vaccine is recommended for pregnant women who are in a high-risk category.
Theres no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.
And, as its an inactivated vaccine, the risk to the unborn baby is likely to be negligible .
Who Is Eligible For Hepatitis B Vaccination
Hepatitis B vaccination is recommended for people with chronic liver disease and/or hepatitis C who are seronegative for hepatitis B. This is because they may have an increased risk of hepatitis B and/or severe liver disease after hepatitis B. Adult-formulation hepatitis B vaccine should be given in a 3-dose schedule.
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 CDCs 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 persons 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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Other Reported Adverse Events And Conditions
While serious events and chronic illnesses such as chronic fatigue syndrome, multiple sclerosis, Guillain-Barré syndrome, rheumatoid arthritis and sudden infant death syndrome have been alleged or reported following HB vaccination, no evidence of a causal association has been demonstrated in a number of studies.
Who Needs A Hepatitis A Vaccine

The Centers for Disease Control and Prevention recommends hepatitis A vaccination for all children in the United States when they are one year of age, all children and teens through age 18 who were not pre- viously vaccinated, certain children age 6 through 11 months who are traveling outside the U.S., all adults …
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What Are Dosages Of Hepatitis B Vaccine
Dosages of Hepatitis B Vaccine:
Dosage Considerations Should be Given as Follows:
- Engerix B: 1 mL intramuscularly at 0, 1, and 6 months
- Recombivax HB: 1 mL intramuscularly at 0, 1, and 6 months
- Adults receiving dialysis or other immunocompromising conditions
- Recombivax HB : 40 mcg intramuscularly at 0, 1, and 6 months, OR
- Engerix-B : 40 mcg intramuscularly at 0, 1, and 6 months
Routine vaccination
Catch-up vaccination
- Unvaccinated children should complete a 3-dose series
- Children aged 11-15 years: 2-dose series of adult formulation Recombivax HB is licensed for use in children aged 11 through 15 years
Dosing Considerations
- Administer intramuscularly in the deltoid muscle
- Do not give IV/intradermal
Pediatric:
- low blood pressure
- pain when urinating
Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System , 1-800-822-7967
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.
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Why Is The Hepatitis B Vaccine Important
Because of the vaccine, cases of acute hepatitis B have decreased by a lot in the United States. But chronic hepatitis B is still common up to 2.2 million people in the United States have it. Chronic hepatitis B can lead to serious liver problems and even death.
Getting vaccinated is the best way to prevent hepatitis B.
Hepatitis B is a liver disease caused by a virus. There are 2 types of hepatitis B:
- Acute hepatitis B
- Chronic hepatitis B
Many children who get acute hepatitis B dont have any symptoms, but most adults do. Symptoms may include:
- Dark pee or clay-colored poop
- Pain in the muscles, joints, and stomach
Acute hepatitis B symptoms usually last a few weeks but they can last as long as 6 months.
If the acute hepatitis B infection does not go away after 6 months, its considered a chronic hepatitis B infection. Most people who have chronic hepatitis B dont have symptoms at first. But chronic hepatitis B is a lifelong illness that can lead to serious and possibly deadly liver problems, like:
- Has sex with a person who has hepatitis B
- Touches the blood or open sores of a person who has hepatitis B
All children and most adults need to get the hepatitis B vaccine.
Infants and children
All children need to get the hepatitis B vaccine as part of their routine vaccine schedule.
Children need 3 doses of the vaccine at the following ages:
- Birth for the first dose
- 1 through 2 months for the second dose
- 6 through 18 months for the third dose
Adults
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I Received My Vaccine Years Ago
If it has been years since you have been vaccinated, you may need or may request a hepatitis B surface antibody titer blood test to confirm that you are still protected. A person is considered protected if they have a positive anti-HBs or HBsAb test result greater than 10 mIU/mL. Sometimes these test results are under 10 and there is concern whether these low levels will still provide protection against hepatitis B. Anti-HBs or HBsAb test results can decrease over time, but an individual can still be protected even if the test results are less than 10 mIU/mL.
If your test results are low, your doctor may recommend a booster shot or a repeat of the series. If you confirm you completed the vaccine series, you can get a booster dose of the vaccine. Your surface antibody level will be tested again 1 or 2 months after the booster. If the blood test result is greater than 10 mIU/mL, then you are protected and will not require an additional booster shot in the future. If a booster shot does not result in a level greater than 10, then complete the remaining two-doses of the vaccine series and recheck the levels again after 1-2 months. Retain a copy of the anti-HBs titer test as proof of protection.
Who Should Get The Hbv Vaccine
The Centers for Disease Control and Prevention recommends that all children and adults up to age 59 should receive the hepatitis B vaccine.
Infants should get their first hepatitis B vaccine within 24 hours of birth and complete their doses by age 6 to 18 months.
All unvaccinated children and adults through age 59 should receive the vaccine. Also, unvaccinated adults over the age 60 who are at risk of hepatitis B should get the vaccine.
Adults over age 60 who are not at risk of hepatitis B may also choose to get the shot.
Several types of the HBV vaccine are also safe to administer to pregnant women.
- people who have had more than one sex partner in the last 6 months
- men who have sex with men
- people seeking treatment for a sexually transmitted infection
- people whose partners or household members have hepatitis B
- people who inject drugs
- people who live or work in care facilities
- people who are on dialysis
- travelers to countries where hepatitis B is common
- people with chronic liver disease, HIV, or hepatitis C
- people who are in jail or prison
People who have diabetes should talk with a healthcare professional about their risk for contracting hepatitis B.
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I Am A Healthcare Worker Who Did Not Develop Hepatitis B Antibodies After Immunization What Should I Do
Two versions of hepatitis B vaccine are available. One, called Heplisav-B, contains a novel adjuvant that was not present in previous versions used by adults . Some people did not respond to the older version hepatitis B vaccine. In fact, in a group of adults younger than 40 years of age who received two doses of the older version vaccine 75 of 100 were protected. Following the third dose, this number increased to 90 of 100. However, people older than 40 years of age were less likely to respond to the vaccine with increasing age. On the other hand, 90 to 100 of 100 adults 18 years of age and older respond to Heplisav-B, which was approved for use in 2018.
About 5-10 of every 100 children and adults younger than 40 years of age do not respond to the third dose of the hepatitis B vaccine. Some of these people will be recommended to get vaccinated again. About 5 of 100 people will still not respond after getting all recommended doses of both series. Note that children younger than 18 years of age cannot get Heplisav-B.
If the people who do not respond to vaccination are determined not to have chronic hepatitis B, they will be reliant on taking precautions to reduce the chance of exposure and relying on those around them for protection. In other words, these people will be reliant on herd immunity.
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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Us Infant 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.
3-Dose Vaccine Series for Infants
Since 1991, ALL medically stable infants with a birth weight of at least 2,000 g in the U.S. are recommended to receive the first dose of hepatitis B vaccine within 24 hours of birth. The additional 2 doses are given at 1 month and 6 months of age.
4-Dose Vaccine Combination Series for Infants
Combination vaccines, such as the pentavalent and hexavalent vaccines, include protection against 5 or 6 diseases, including hepatitis B. The first shot is usually given at 6 weeks of age, but in order to protect infants from hepatitis B beginning at birth, a monovalent or single dose of the hepatitis B vaccine is also recommended within 24 hours of birth. The hepatitis B vaccine series can then be completed with the pentavalent or hexavalent vaccine with the recommended schedule.
What About The Hepatitis B Vaccine

The best way to prevent Hepatitis B is to get vaccinated. The Hepatitis B vaccine is now given to most babies at birth, but many adults have not had it. A member of our CVS pharmacy® team or a MinuteClinic® provider can talk with you about your risk for getting Hepatitis B and answer your questions about the vaccine. They can also administer the vaccine if you decide it is right for you.
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What Should I Tell My Health Care Provider Before Receiving A Hepatitis B Vaccine
Before receiving a hepatitis B vaccine, tell your health care provider:
Ask your health care provider about possible side effects from getting a hepatitis B vaccine. Your health care provider will tell you what to do if you have side effects.
Vaccination Is The Best Way To Prevent Hepatitis A And B Infection
Narrator: ÂYou are a traveller…Â .
Narrator: …and you are already dreaming of your next getaway. .
Disclaimer on-screen reads: TWINRIX is a combined hepatitis A and hepatitis B vaccine used in adults, adolescents, children, and infants over the age of 1 year to prevent hepatitis A and hepatitis B diseases
Narrator: ÂWhile your travel plans probably donÂt include hepatitis A or hepatitis B…Â .
Disclaimer reads: 100% protection cannot be guaranteed and booster doses may be required.
Narrator: Â…you know that many common travel activities can put you at risk of acquiring these two serious liver diseases…Â .
Disclaimer reads: TWINRIX does not protect against hepatitis C or E, and is not indicated to treat or reduce the severity of hepatitis A or B infections. .
Narrator: Â…which is why you plan on talking to your doctor about TWINRIX, right? … Of course, right…Â Â…because you are a traveller.Â
Video concludes with TWINRIX logo, GSK logo, You are a traveller slogan, and safety information: Very commonly reported adverse events in adults were pain or discomfort, redness at the infection site, headache, and tiredness. Common adverse events were swelling at the injection site, diarrhea, nausea and vomiting, and generally feeling unwell. Allergic reactions may also occur. Full product information can be found on Twinrix.ca. If you need to report an adverse event, please call 1-800-387-7374.
Twinrix.ca
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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.
What Are The Side Effects
The most common of the hepatitis B vaccine are mild and include:
- Sore arm from the shot.
Prepare for your child’s vaccine visit and learn about how you can:
- Research vaccines and ready your child before the visit
- Comfort your child during the appointment
- Care for your child after the shot
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Advisory Committee On Immunization Practices
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices provide recommendations for the hepatitis B vaccine. The following include persons recommended to receive the hepatitis B vaccination :
- Adults aged 60 years and older with risk factors for hepatitis B:
-
Persons at risk for infection by sexual exposure
- Sex partners of persons testing positive for HBsAg
- Sexually active persons who are not in a long-term, mutually monogamous relationship
- Persons seeking evaluation or treatment for a sexually transmitted infection
- Men who have sex with men
Persons at risk for infection by percutaneous or mucosal exposure to blood
For booster/revaccination recommendations, see Booster Dose Vaccination below.
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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Concurrent Administration Of Vaccines
HB-containing vaccines may be administered concomitantly with other vaccines or with HBIg. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections.
Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
What Do I Do If I Am Exposed To Hepatitis B

Contact your healthcare provider as soon as possible after the exposure. If you have not been vaccinated or are incompletely vaccinated, it may make sense for you to get a shot of hepatitis B immune globulin as soon as possible . HBIG provides short-term protection against the hepatitis B virus. When given shortly after an exposure , HBIG is 70-75% effective in preventing hepatitis B infection. Hepatitis B vaccination can be given at the same time, for long-term protection.
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