Who should be vaccinated against Hepatitis B?

Benefits of the HBV Vaccine

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Person receiving a vaccine. Jeffrey Hamilton/Digital Vision/Getty Images

The hepatitis B (HBV) vaccine is an extremely safe vaccine that is recommended for use in all children. However, routine childhood vaccination is a relatively recent recommendation, which has only been in place since 1990, and vaccination has not yet been universally implemented. Therefore, some older children and many adults have never been vaccinated against HBV, which leaves them at risk of acute or chronic hepatitis infection.

The CDC recommends that all children and adolescents should be vaccinated against HPV. Furthermore, adults who have not yet been vaccinated against hepatitis B should consider vaccination if they are at risk of infection. This includes people who:

  • have more than one sexual partner
  • live with someone with HBV
  • have a sexual partner with HBV
  • have ever sought care for STDs or HIV
  • are men who have sex with men
  • inject drugs
  • work someplace where they may have contact with blood
  • work in, or frequently visit, a clinic for the developmentally disabled
  • have end stage renal disease, liver disease, or need dialysis
  • have diabetes and are under age 60.
  • live or travel for more than 6 months a year in areas where hepatitis B is still common
  • are prisoners in a correctional facility

Older adults and pregnant women should also discuss vaccination with their doctor.

Who Should NOT Be Vaccinated Against HBV?

Although hepatitis B vaccination is safe for most of the population, there are a few groups of people who should not get the HBV vaccine.

These include:

  • people who have serious allergies to yeast or other vaccine components
  • people who have had a serious allergic reaction to an earlier HBV vaccination
  • people who are moderately to severely ill at the time they are scheduled to be vaccinated

It is also important to know that although vaccination can not infect you with hepatitis, for the first 28 days after each injection you may be instructed not to donate blood.

This is because the vaccine can sometimes appear to be an infection on a blood test.

How Do I Know if I've Been Vaccinated Against Hepatitis B?

Many adults have no knowledge of whether they were vaccinated for hepatitis B as children. Fortunately, it is possible to determine whether or not you are immune to hepatitis B through a group of blood tests.

Typically, if your doctor wants to test whether you have been vaccinated for, or infected with, hepatitis B, she will do so using a series of three tests.These tests look for:

  • Hepatitis B surface antigen (HBsAg) - which is present in people actively infected with HBV and those who have been recently vaccinated, since it is the protein used in the vaccine

  • Hepatitis B surface antibody (anti-HBs) - which is found in anyone who is immune to HBV due to either successful vaccination or an infection that the body cleared on its own

  • Total Hepatitis B core antibody (anti-HBc) -  which is only found in people who were infected with HBV, not those who were vaccinated

    In other words, if you have ever been vaccinated for HBV, you will have a positive anti-HBs test and negative HBsAG and anti-HBc tests. People who have ever been infected with HBV and become immune will have positive anti-HBs and anti-HBc tests. They will also have a positive HBsAg test if they have an active infection.

    People who currently have an active infection with hepatitis B, whether it is chronic or acute, will have a negative anti-HBs test.

    Only people for whom all tests are negative need to consider vaccination for HBV.

    How Do I Get the Hepatitis B Vaccine?

    If you are interested in hepatitis B vaccination, talk to your doctor or visit an STD clinic. There currently are several different HBV vaccines available, although most adults will get a standard three dose vaccine where the second dose is given one month after the first, and the third dose 5 months after that. Vaccines with other dosing schedules are available, but they are only used in specific circumstances.

    Note: A vaccine for hepatitis A is also available, but there is not yet a vaccine for hepatitis C.

    Sources:

    Centers for Disease Control and Prevention (2012). Vaccine Information Statement - Hepatitis B. Retrieved from: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/hep-b.html November 6, 2013.

    Centers for Disease Control and Prevention (2012).  Hepatitis B Information for Health Professionals. Retrieved from: http://www.cdc.gov/hepatitis/hbv/hbvfaq.htm November 6, 2013.

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