Stephen J. Schueler, M.D.

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Hepatitis B Prevention

Hepatitis B is prevented by the hepatitis vaccine. In the US the vaccine is given to all children. Adults who have not been vaccinated receive hepatitis B immunoglobulin if they are exposed to someone with hepatitis B. This is then followed by a hepatitis B vaccination.

Prevention of hepatitis B includes:

  • Vaccination for hepatitis B:
    • Healthcare workers who care for patients
    • For those who practice anal sex
    • For those who abuse intravenous drugs
    • For those who have hepatitis A or hepatitis C
  • Immune globulin for hepatitis B:
    • For those who have not received the vaccine and are exposed to hepatitis B
  • Wash hands after using the bathroom.
  • Wash hands after changing diapers.
  • Avoid body-piercing
  • Avoid contact with blood
  • Avoid multiple sex partners
  • Avoid tattoos
  • Do not abuse intravenous drugs
  • Practice safe sex:
    • Use condoms.

Hepatitis B Vaccine

In 2001, the FDA approved a combination of hepatitis A and hepatitis B vaccine marketed as the trade name Twinrix. This combination allows adults to receive protection against both forms of hepatitis with three injections instead of five. Hepatitis B vaccine is also present in PEDIARIX and Engerix-B combination vaccines.

The hepatitis B vaccine protects against infection with the hepatitis B virus. Everyone who is under 18 years of age should get hepatitis B vaccine. Unimmunized children younger than 18 years may begin the series at any age. Adults should get the hepatitis B vaccine if they are at risk for infection.

Indications for use

  • Dialysis nurses
  • Dialysis patients
  • Health care workers
  • Infants with hepatitis B infected mothers
  • Institutionalized patients
  • Intravenous drug users
  • Male homosexuals.
  • Sexually promiscuous persons
  • Geographical area; your risk is also higher if your parents were born in:
    • Southeast Asia
    • Africa
    • Amazon Basin in South America
    • Pacific Islands
    • Middle East

Those who have had a serious reaction to baker's yeast in the past should not receive this vaccine.

Complete immunity to hepatitis B virus will require the administration of three boosters:
  • In most cases the first booster may administered anywhere from birth to through the second month of life. Infants born to hepatitis B infected mothers should receive vaccine and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth at separate sites.
  • The second booster should be administered at least one month after the first dose. Infants born to hepatitis B infected mothers should receive the second dose at least one month after the first dose.
  • The third booster should be given at least 2 months after the second, but not before six months of age. Infants born to hepatitis B infected mothers should receive their third dose at least four months after the first and two months after the second, but not before 6 months of age.
  • Illness may require a shot to be delayed. Only your doctor can make this determination.

Side Effects
Mild problems:
  • Soreness at the vaccination site (1 out of 11 children)
  • Mild to moderate fever ( 1 out of 14 children)

Severe problems:

Continue to Hepatitis B Outlook

Last Updated: Dec 15, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Hepatitis B References
  1. Murdoch DL, Goa K, Figgitt DP. Combined hepatitis A and B vaccines: a review of their immunogenicity and tolerability. Drugs. 2003;63(23):2625-49. [14636084]
  2. Oncu S, Oncu S, Sakarya S. Hepatitis A and B seropositivity among medical students. Health Policy. 2005 Sep 28;74(1):39-45. [16098410]
  3. Papatheodoridis GV, Hadziyannis SJ. Review article: current management of chronic hepatitis B. Aliment Pharmacol Ther. 2004 Jan 1;19(1):25-37. [14687164]
  4. Rich JD, Ching CG, Lally MA, Gaitanis MM, Schwartzapfel B, Charuvastra A, Beckwith CG, Flanigan TP. A review of the case for hepatitis B vaccination of high-risk adults. Am J Med. 2003 Mar;114(4):316-8. [12681460]
  5. Rischitelli G, Harris J, McCauley L, Gershon R, Guidotti T. The risk of acquiring hepatitis B or C among public safety workers: a systematic review. Am J Prev Med. 2001 May;20(4):299-306. [11331121]
  6. Robins GW, Scott LJ, Keating GM. Peginterferon-alpha-2a (40kD): a review of its use in the management of patients with chronic hepatitis B. Drugs. 2005;65(6):809-25. [15819595]
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