Hepatitis B Vaccine Recommendations and Safety

The Hepatitis B vaccine is administered in a series of 3 shots.

The Advisory Committee on Immunization Practices and ACOG recommend Hepatitis B vaccination for all infants at birth. Infants should receive a birth dose of Hepatitis B vaccine before leaving the hospital. The second dose should be administered at 1-2 months, and the third dose at 6-18 months.

The hepatitis B vaccine is also recommended for all individuals through 18 years of age and all adults who want the vaccine or who are at risk for hepatitis B virus (HBV).

According to the ACIP Adult Immunization Schedule, vaccinate persons with any of the following indications and any person seeking protection from hepatitis B virus (HBV) infection:

  • sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than 1 sex partner during the previous 6 months); persons seeking evaluation or treatment for a sexually transmitted disease (STD); current or recent injection drug users; and men who have sex with men; — health care personnel and public safety workers who are potentially exposed to blood or other infectious body fluids;
  • persons with diabetes who are younger than age 60 years as soon as feasible after diagnosis; persons with diabetes who are age 60 years or older at the discretion of the treating clinician based on the likelihood of acquiring HBV infection, including the risk posed by an increased need for assisted blood glucose monitoring in long-term care facilities, the likelihood of experiencing chronic sequelae if infected with HBV, and the likelihood of immune response to vaccination;
  • persons with end-stage renal disease, including patients receiving hemo- dialysis, persons with HIV infection, and persons with chronic liver disease;
  • household contacts and sex partners of hepatitis B surface antigen–positive persons, clients and staff members of institutions for persons with developmental disabilities, and international travelers to countries with high or intermediate prevalence of chronic HBV infection; and
  • all adults in the following settings: STD treatment facilities, HIV testing and treatment facilities, facilities providing drug abuse treatment and prevention services, health care settings targeting services to injection drug users or men who have sex with men, correctional facilities, endstage renal disease programs and facilities for chronic hemodialysis patients, and institutions and nonresidential day care facilities for persons with developmental disabilities.

Administer missing doses to complete a 3-dose series of hepatitis B vaccine to those persons not vaccinated or not completely vaccinated. The second dose should be administered 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose). If the combined hepatitis A and hepatitis B vaccine (Twinrix) is used, give 3 doses at 0, 1, and 6 months.

Alternatively, a 4-dose Twinrix schedule, administered on days 0, 7, and 21 to 30 followed by a booster dose at month 12 may be used.

Adult patients receiving hemodialysis or with other immunocompromising conditions should receive 1 dose of 40 mcg/mL (Recombivax HB) administered on a 3-dose schedule at 0, 1, and 6 months or 2 doses of 20 mcg/mL (Engerix-B) administered on a 4-dose schedule at 0, 1, 2, and 6 months.

The vaccine can be given to pregnant or nursing women.

See the Adult Immunization Schedule for a complete overview of ACIP Hepatitis B Vaccination recommendations.


The Hepatitis B vaccine is safe. Soreness at the injection site is the most common side effect reported. As with any medicine, there are very small risks that a serious problem could occur after getting the vaccine. However, the potential risks associated with Hepatitis B are much greater than the risks the vaccine poses. Since the vaccine became available in 1982, more than 100 million people have received Hepatitis B vaccine in the United States and no serious side effects have been reported.

The Hepatitis B vaccine is not recommended for people who have had serious allergic reactions to a prior dose of Hepatitis B vaccine or to any part of the vaccine. Also, it not recommended for anyone who is allergic to yeast because yeast is used when making the vaccine. Tell your doctor if you have any severe allergies.


For more information regarding Hepatitis B vaccine safety, visit CDC's webpage Hepatitis B Vaccine Safety

Source: http://www.cdc.gov/hepatitis/B/bFAQ.htm#bFAQ38

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