The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis B (HepB) vaccination among all adults aged 19–59 years and adults > 60 years with risk factors for hepatitis B or without identified risk factors but seeking protection.
Current Issues in Immunization Webinar: Update on ACIP Recommendations for Hepatitis B Vaccination
Adults recommended to receive HepB vaccine:
The Advisory Committee on Immunization Practices (ACIP) recommends that the following people should receive hepatitis B vaccination:
- All infants
- Unvaccinated children aged <19 years
- Adults aged 19 through 59 years
- Adults aged 60 years and older with risk factors for hepatitis B
The following groups may receive hepatitis B vaccination:
- Adults aged 60 years and older without known risk factors for hepatitis B
Risk factors for hepatitis B
- Persons at risk for infection by sexual exposure
- Sex partners of persons who test positive for hepatitis B surface antigen (HBsAg)
- Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than one sex partner during the previous 6 months)
- Persons seeking evaluation or treatment for a sexually transmitted infection
- Men who have sex with men
- Persons at risk for infection by percutaneous or mucosal exposure to blood
- Persons with current or recent injection use
- Household contacts of persons who test positive for HBsAg
- Residents and staff of facilities for persons with developmental disabilities
- Health care and public safety personnel with reasonably anticipated risk for exposure to blood or blood-contaminated body fluids
- Persons on maintenance dialysis, including in-center or home hemodialysis and peritoneal dialysis, and persons who are predialysis
- Persons with diabetes at the discretion of the treating clinician
- Others
- International travelers to countries with high or intermediate levels of endemic hepatitis B virus (HBV) infection (HBsAg prevalence of ≥2%)
- Persons with hepatitis C virus infection
- Persons with chronic liver disease (including, but not limited to, persons with cirrhosis, fatty liver disease, alcoholic liver disease, autoimmune hepatitis, or an alanine aminotransferase [ALT] or aspartate aminotransferase [AST] level greater than twice the upper limit of normal)
- Persons with HIV infection
- Incarcerated persons
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NAIIS Call to Action
At least 3 out of every 4 adults are missing one or more routinely recommended vaccines. Providers can take actions to improve vaccination of adults. Learn more about the National Adult and Influenza Immunization Summit (NAIIS) Call to Action:
- Strategies for Increasing Adult Vaccination Rates
Implementation Guidelines
To ensure vaccination of persons at risk for HBV infection, health care providers should:
- Offer HepB vaccination to all adults aged 19–59 years who have not previously completed vaccination, as well as adults > 60 years with risk factors for hepatitis B or without identified risk factors but seeking protection.
- Implement standing orders to administer HepB vaccine as part of routine services to adults who have not completed the vaccine series.
- Offer HepB vaccination, when feasible, in outreach and other settings in which services are provided to persons at risk for HBV infection (e.g., syringe services programs, HIV testing sites, HIV prevention programs, homeless shelters).
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Vaccine for Hepatitis B
Hepatitis B Vaccine
It takes only a few shots to protect yourself and your loved ones against hepatitis B for a lifetime.
The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years. The hepatitis B vaccine is also recommended for adults living with diabetes and those at high risk for infection due to their jobs, lifestyle, living situations, or country of birth. Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease.
The hepatitis B vaccine is also known as the first “anti-cancer” vaccine because it prevents hepatitis B, the leading cause of liver cancer worldwide.
You cannot get hepatitis B from the vaccine. All hepatitis B vaccines that have been used since 1986 are made synthetically – meaning the hepatitis B vaccines do not contain any blood products. Learn more.
If you have a current HBV infection (HBsAg positive) or have recovered from a past HBV infection, the hepatitis B vaccine series will not benefit you or clear the virus. However, the vaccine can provide a lifetime of protection for loved ones who do not have hepatitis B and get the vaccine as soon as possible. Testing is the only way to know if you or your loved ones have a current infection or have recovered from a past infection.
Hepatitis B Vaccine Recommendations
International: The World Health Organization (WHO) recommends the hepatitis B vaccine for all newborns, children up to 18 years of age, and all adults at higher risk for infection (see below for risk factors).
United States: The U.S. Centers for Disease Control and Prevention (CDC) recommends the hepatitis B vaccine for all newborns, children up to age 18, adults 19-59 years of age, and adults 60 and older who are at high-risk for infection (see below for risk factors)
Persons most at risk for infection:
Every person may be at some risk for a hepatitis B infection during their lifetime, so all people should consider getting the hepatitis B vaccine. However, some groups are more likely to be exposed to the hepatitis B virus. See below for the CDC’s list of people at increased risk of infection:
Infants born to mothers who are living with hepatitis B
All infants, beginning at birth
Unvaccinated children aged <19
Susceptible sexual partners of people with hepatitis B infection
Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., more than one sex partner during the previous six months)
Persons seeking evaluation or treatment for a sexually transmitted infection
Men who have sex with men
People with current or recent drug use
Susceptible household contacts of people with hepatitis B infection
Healthcare and public safety workers at risk for exposure to blood
Persons with end-stage renal disease, including pre-dialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
Residents and staff of facilities for persons with developmental disabilities
Travelers to and families adopting from countries where hepatitis B is common (e.g. Asia, Africa, South America, Pacific Islands, Eastern Europe, and the Middle East)
Persons with chronic liver disease, other than hepatitis B (e.g. cirrhosis, fatty liver disease, etc.)
Persons with hepatitis C infection
Persons with HIV infection
People with diabetes, as decided by their provider
All persons seeking protection from HBV infection — acknowledgment of a specific risk factor is not a requirement for vaccination
Three-Dose Hepatitis B Vaccine Schedule
The hepatitis B vaccine is available at your doctor's office and local health department or clinic. All doses of the vaccine are required in order to be fully protected against hepatitis B. It is important to remember that babies born to infected mothers must receive the first dose of hepatitis B vaccine in the delivery room or within the first 12 hours of life (learn more about hepatitis B and pregnancy).
- 1st Shot - At any given time, but newborns should receive this dose in the delivery room
- 2nd Shot - At least one month (or 28 days) after the 1st shot
- 3rd Shot - At least 4 months (16 weeks) after the 1st shot and 2 months after the 2nd shot. Infants should be a minimum of 24 weeks old at the time of the 3rd shot.
You do not need to restart the hepatitis B vaccine series if you miss any of the shots. For example, if you start the vaccine series and stop, then get the 2nd shot when you can and make sure to get the 3rd shot at least two months later. Or, if you get the first two doses of vaccine and miss the third dose, then just schedule the last shot when you can.
To be certain that you are protected against hepatitis B, ask for a simple blood test to check your “antibody titers” that will confirm whether the vaccination was successful.
Two-Dose Hepatitis B Vaccine Schedule for Adults
In November 2017, a vaccine was approved by the FDA for use in the U.S. Heplisav-B (Dynavax) is a two-dose vaccine approved for use in adults aged 18 and older. The vaccine is administered as two doses given one-month apart.
Ask your doctor about the 2-dose vaccine. For assistance accessing this vaccine, you can contact Heplisav-B's Access Navigator at 1-844-375-4728.
Hepatitis B Vaccine Safety and Side Effects
More than 1 billion doses of the hepatitis B vaccine have been given worldwide and it is considered one of the safest and most effective vaccines ever made. Numerous studies looking at the vaccine's safety have been conducted by the World Health Organization, U.S. Centers for Disease Control and Prevention, and many different medical societies.
No evidence has been found that the hepatitis B vaccine causes sudden infant deaths (SIDs), autism, multiple sclerosis, or other neurological disorders.
Common side effects from the hepatitis B vaccine may include soreness, swelling and redness at the injection site. The vaccine may not be recommended for those with documented yeast allergies or a history of an adverse reaction to the vaccine.
The HEPLISAV-B® Pregnancy Registry Now Open and Enrolling
The HEPLISAV-B® [Hepatitis B Vaccine (Recombinant), Adjuvanted] Pregnancy Registry is an observational study being conducted in the United States (US) to evaluate pregnancy outcomes in persons vaccinated with HEPLISAV-B® within 28 days prior to conception or at any time during pregnancy. The purpose of the registry is to understand the effect of vaccination with HEPLISAV-B® during pregnancy.
The information collected will provide doctors with an understanding of the effect (if any) of HEPLISAV-B® exposure during pregnancy. This Registry is sponsored by Dynavax Technologies Corporation and is managed by Pharmaceutical Product Development (PPD), Inc. For additional information please call 1-844-443-7734 or email .