Immunizations - Hepatitis B

Highlights	Hepatitis A	Haemophilus Type B
Introduction	Hepatitis B	Smallpox
Diptheria, Tetanus, and Pertussis	Poliomyelitis	Other Vaccinations
Measles, Mumps, and Rubella	Pneumococcal Pneumonia	Resources
Varicella-Zoster Virus (Chickenpox)	Viral Influenza	References

Hepatitis B

About 350 million people carry hepatitis B virus (HBV) worldwide, and each year 600,000 people die, mostly due to cirrhosis and liver cancers that develop in people with the chronic form of this disease. In the US, more than 1 million people have chronic hepatitis B.

Hepatitis B is also known as serum hepatitis. It spreads through blood and sexual contact. The infection is seen with increased frequency among intravenous drug users who share needles and among the homosexual population. This photograph is an electronmicroscopic image of hepatitis B virus particles. (Courtesy of the CDC.)

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The average lifetime risk for acquiring the infection in the US is about 5%. Most of these infections are acquired during childhood. Pregnant women with hepatitis B can transmit the virus to their babies. Even if they are not infected at birth, unvaccinated children of infected mothers run a 60% risk of developing hepatitis B before age five. Universal vaccination against this disease during childhood, then, is very important.

Vaccine for Hepatitis B

Several inactivated virus vaccines, including Recombivax HB, GenHevac B, Hepagene, and Engerix-B, can prevent hepatitis B. Twinrix is a vaccine against both hepatitis A and B. They are safe, even for infants and children. Vaccination programs are proving to reduce the risk for liver cancer.

Click the icon to see an image of hepatitis B.

Hepatitis B Vaccine for Early Childhood. Experts now recommend that all infants and children not previously vaccinated be immunized by the time they reach seventh grade. Typical schedules for hepatitis B vaccinations in childhood are as follows:

All infants should receive the hepatitis B vaccine soon after birth and before hospital discharge. (The first dose may also be given by age 2 months if the mother has no evidence of infection.) The second dose should be given at one to four months (at least four to six weeks after first dose); and the third between six and 18 months (at least 16 weeks after first dose and eight weeks after second dose). (A fourth dose may also be given as part of a combination vaccine.) This is a safe vaccine, even in newborns, and parents should be sure their infants are immunized.
Infants of mothers infected with HBV should be treated with immune globulin plus the hepatitis vaccine within 12 hours of birth. The second dose should be given at one to two months and the third at six months. Infants should be tested for antibody status at nine to 15 months to see if they are chronic virus carriers or need to be re-vaccinated. Immunization rates are still too low in this group.
When it is not known if a mother is infected or not, the infant should receive the vaccine within 12 hours of birth. The mother''s blood should then be tested right away. If she is infected, the infant should receive immune globulin as soon as possible (no later than a week).
Children who are between 11 and 12 and who have not been immunized should receive two or three doses of the vaccine (depending on the brand) given over a few months.