Hepatitis B Vaccine

Ramsha Ansari
MBBS, Medical Editorial Team, Pediatric Oncall.
First Author
Nitin Shah
Consultant Pediatrician, B J Wadia Hospital for Children, Mumbai, India

First Created: 01/09/2001  Last Updated: 01/19/2024

Patient Education

What is hepatitis B?

Hepatitis B (HBV) is a type of virus that leads to jaundice and infective hepatitis. HBV leads to acute hepatitis and most of the patients recover. 5 - 10% develop a chronic carrier state. Again of these carriers, 30% will develop chronic liver disease and some will develop liver cancer. 1-2% of patients with HBV infection develop fulminant hepatitis which carries >80% mortality.

What are the modes of transmission of HBV?

Vertical transmission occurs from Hepatitis B positive pregnant women to their babies during the perinatal period. Transmission may also occur due to close contact e.g. amongst family members or at daycare centers. It can also spread via blood products, contaminated needles, surgical instruments, IV drug abuse, tattooing, acupuncture needles, ear piercing, etc. Last is the sexual route of transmission, which occurs when one partner is infected.

What is hepatitis B vaccine?

The Hepatitis B vaccine protects against infection by HBV. Ideally, it should be given to every individual.

What is the schedule of Hepatitis B immunization?

The schedule consists of giving 3-4 doses depending on the age of the child.

The first dose is administered within 24 hours of birth. The subsequent doses are administered at 6 weeks, 10 weeks and 14 weeks along with other vaccines like DPT / HiB / IPV.

For children and adults, 3 doses are required. 2 doses are given 1 month apart and the third dose is given 6 months after the first dose.

No booster doses are required for the Hepatitis B Vaccines as the 3-4 doses usually provide life-long protection.

What if the child comes late for subsequent doses?

There is no need to restart the course. Instead, just complete the remaining doses as per the original schedule. However such delays are not desirable as the child remains unprotected till the course of 3 doses is completed.

What are the side effects of the Hepatitis B vaccine?

The side effects of the vaccines are very few if any. Local reactions including redness, pain, and swelling at the injection site.

What about immunocompromised children?

Children with leukemia, on chemotherapy, multi - transfused thalassemia, patients on high dose long-term steroids, and patients on hemodialysis have poor seroconversion following conventional schedule. Hence it is recommended to double the dose of vaccine. Even children with Down's syndrome show poor seroconversion & titers and should be given double the normal doses

Should Hepatitis B vaccine be given to a carrier or to a patient who has recovered from HBV infection?

Neither the carrier nor the patient who has recovered needs the Hepatitis B vaccine. In fact, a patient of HBV infection develops protective antibodies to surface antigen (anti - HBs) on recovery. There is no risk associated with vaccination, but it is a total waste.

Can you use different Hepatitis B vaccines interchangeably?

If there is no other option, yes, they can be interchanged.

Can you give Hepatitis B vaccine along with other vaccines?

Yes, it can be given together with other vaccines. The vaccines should be given on the same day but at different sites using different syringes or as combination vaccine-like DPT+Hepatitis B vaccine.

Can you give Hepatitis B vaccine along with other vaccines?

What is the schedule for babies born to mothers who are infected with Hepatitis B virus?

The babies born to mothers who are infected with Hepatitis B virus, have to receive a special injection at birth, along with the regular vaccine schedule. This injection is called ‘Hepatitis B Immunoglobulin’ HBIG. This method is 95% effective in reducing vertical transmission of the virus.

Who should receive the Hepatitis B vaccine?

All infants and children should receive this vaccine to help them prevent against future Hepatitis B infection.

Who should not receive the Hepatitis B vaccine?

Children who had a severe allergic reaction to the previous doses should not receive the vaccine. Individuals with severe allergies to any component of the vaccine should not receive the vaccine either.

1. Locarnini S, Hatzakis A, Chen DS, Anna Lok A. Strategies to control hepatitis B: Public policy, epidemiology, vaccine and drugs. J Hepatology April 2015; 62 (1), S76–S86.
2. Rajeev Kumar and Jacob Puliyel. Utility of Hepatitis B Vaccination in India- Pediatrician’s Perspective. Indian Pediatr 2014; 51: 870-872.
3. Lahariya, C, Subramanya BP, Sosler S. An assessment of hepatitis B vaccine introduction in India: Lessons for roll out and scale up of new vaccines in immunization programs. Indian J Pub Health, 2013; 57 (1): 8-14. http://www.ijph.in/article.asp?issn=0019-557X
4. CDC 24/7 and ACIP; Hepatitis B vaccination Guidelines and Recommendations. http://www.cdc.gov/hepatitis/hbv/vaccchildren.htm
5. Van Herck K1, Van Damme P., Benefits of early hepatitis B immunization programs for newborns and infants. Pediatr Infect Dis J. 2008 Oct; 27(10):861-9.
6. Acvip.org (Internet) Haemophilus Influenza Type B [HiB] Conjugate Vaccine Advisory Committee on Vaccines & Immunization Practices. Available from: https://acvip.org/

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