Immunizations - Hepatitis B

Hepatitis B vaccine protection lasts at least eight to 10 years. Booster shots after that may be recommended depending on continuing risk, such as sexual exposure.

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Hepatitis B Vaccine for Adults. The following adults are at very high risk and should be vaccinated:

Healthcare and public safety workers who may be exposed to blood products. Such individuals have a risk for hepatitis B virus that ranges from 15 - 30%.
People in the same household as HBV infected individuals. (Unvaccinated people who have had intimate exposure to people with HBV may be protected with immune globulin, which is sometimes administered with the vaccine.)
Travelers to developing countries.
Patients who require transfusions and have not been infected with HBV. (Those with blood clotting disorders should have the vaccination administered under the skin not injected in the muscle.)
Sexually active homosexual or heterosexual individuals with multiple partners.
People with any sexually transmitted diseases.

Other people at risk who would benefit from vaccinations include:

Patients and workers in mental institutions and morticians.
Patients on hemodialysis. (People on hemodialysis may need larger doses or boosters; they also may need to be revaccinated if blood tests indicate they are losing immunity.)
People who use injected drugs.
Pregnant women at risk for the virus should be vaccinated; there is no evidence that the vaccine is dangerous to the fetus.
People receiving treatments or who have conditions that suppress the immune system may need the vaccination, although its benefits for this group are unclear except for those at high risk, such as people with HIV or spleen abnormalities.

Click the icon to see an image of the immune system structures.

The regimen in adults is typically three doses given over six months. One study reported that older adults would benefit from a fourth dose without incurring serious side effects. People with alcoholism may need high doses.

A small percentage of people do not develop immunity even after a vaccine has been given repeatedly. A more potent vaccine is proving to be effective for these people; it loses its effect after five years in about a third of those who receive it.

Side Effects of Hepatitis B Vaccine

Soreness. Soreness at the injection site is the most common side effect.

Nerve Inflammation. There have been some reports of nerve inflammation after vaccinations for hepatitis B, and there has been some concern about three small studies associating the vaccine with a nonsignificant increase in multiple sclerosis. A 2001 study of 121,700 nurses reported no association between the vaccine and a risk for multiple sclerosis, and an earlier report on 260,000 Canadian adolescents also found no higher incidence. Because of even a small theoretical risk of nerve damage in infants, some groups oppose the vaccination in children who are not in high-risk groups. It should be strongly stressed that worldwide, 65 million people with chronic hepatitis are expected to die from liver disease and vaccinations are saving lives. For example, in Taiwan, where infection rates are high and infants are at risk for hepatitis B from infected mothers, vaccination programs have significantly reduced the risk for liver cancer. [For more information see In-Depth Report #59: Hepatitis.]