Hepatitis B Vaccine Schedule: When to Get Vaccinated By Laura Dorwart Laura Dorwart Laura Dorwart is a health journalist with expertise in disability rights, mental health, and pregnancy-related conditions. She has written for publications like SELF, The New York Times, VICE, and The Guardian. Learn about our editorial process Published on June 18, 2022 Medically reviewed by Brian H. Wetchler, DO Medically reviewed by Brian H. Wetchler, DO Brain H. Wetchler, DO, is a board-certified internal medicine physician. He works in private practice at Woodmere Medical Associates in New York. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Infants and Children Adults Who Should Get It? Side Effects Frequently Asked Questions Hepatitis B (sometimes referred to as hep B) is a liver infection caused by the hepatitis B virus (HBV). It typically causes symptoms like stomach pain, dark urine, fatigue, fever, jaundice (yellowing of the skin and eyes), diarrhea, vomiting, and clay-colored stools. In rare cases, hepatitis B can lead to life-threatening complications like liver failure, liver cancer, or cirrhosis (liver scarring). The hepatitis B vaccine is a shot, typically injected into the arm, that protects against hepatitis B in babies, children, and adults. It is an important way to protect yourself and your children from HBV infection. Hepatitis B vaccine is universally recommended for infants, children, and adults up to age 60 without regard for risk factors. It is recommended for those 60 and over who have risk factors and is optional for any in that age group who want protection. This article will discuss the recommended hepatitis vaccine schedule for children and adults, including doses, timing, side effects, and who should get the vaccine. FatCamera / Getty Images Hepatitis B Vaccination Schedule for Children and Infants The Centers for Disease Control and Prevention (CDC) recommends that babies and children receive three 0.5 milliliter doses of either Engerix-B or Recombivax HB, starting just after birth. The current recommended hepatitis B vaccine schedule for children and infants is as follows: Hepatitis B Vaccination Schedule for Infants and Children Hepatitis B Vaccine Dose Age 1 0 (shortly after birth) 2 1–2 months old 3 6–18 months old If your child is undergoing hemodialysis, your healthcare provider may recommend that they receive additional doses of the HBV vaccine. Combination Vaccines The following vaccines are approved by the Food and Drug Administration (FDA) to prevent hepatitis B as well as other conditions: Pediarix prevents hepatitis B, poliomyelitis, diphtheria, tetanus, and pertussis in infants and children ages 6 weeks to 6 years. It is typically given in three doses across six months.Twinrix prevents hepatitis B and hepatitis A in both children and adults. It is delivered in three doses over six months. Adults can receive four doses of Twinrix on a rapid schedule.Vaxelis protects children ages 6 weeks to 4 years against tetanus, diphtheria, hepatitis B, poliomyelitis, and invasive forms of Haemophilus influenzae type b (Hib). It is typically given in three doses with at least four weeks between the first two doses. The third dose should not be given before the age of 6 months. How Common Is Hepatitis B? One U.S. study following trends in hepatitis B infection over a three-year period found that 4.3% of the population had a past or present HBV infection.Estimates suggest that about 240 million people around the world have chronic hepatitis B. Up to 1.89 million people in the United States have a chronic HBV infection. Hepatitis B Vaccination Schedule for Adults The following vaccines are currently approved by the FDA for the prevention of hepatitis B: Engerix-B Recombivax HB Heplisav-B PreHevbrio Adults typically receive the hepatitis B vaccine in a two- or three-dose series. Engerix-B is also offered as a four-dose series for adults who are undergoing hemodialysis (kidney dialysis). The current recommended hepatitis B vaccine schedule for adults who have not previously completed vaccination is as follows: Hepatitis B Vaccination Schedule for Adults Hepatitis B Vaccine Recommended Schedule Engerix-B Three 1 milliliter doses at 0, 1, and 6 months; four 2 milliliter doses at 0, 1, 2, and 6 months (for people undergoing kidney dialysis) Recombivax HB Three 1 milliliter doses at 0, 1, and 6 months Heplisav-B Two 0.5 milliliter doses, one month apart PreHevbrio Three 1 milliliter doses at 0, 1, and 6 months Recommended Vaccines for Adults Who Should Receive the Hepatitis B Vaccine? For most people, the hepatitis B vaccine is safe and effective. About 90% of people who receive three vaccine doses are protected against hepatitis B for over 30 years. The CDC's Advisory Committee on Immunization Practices (ACIP) recommends the hepatitis B vaccine for the following groups: All babies, starting just after birth Children and adolescents under 19 years old Adults ages 19–59 who have not previously completed vaccination Adults ages 60 and over with a high risk of contracting HBV Adults ages 60 and over who do not have any hepatitis B risk factors can receive the hepatitis B vaccine, but it is optional. Hepatitis B spreads when the bodily fluids of an infected person enter another person's body. Sexual contact is one way it can be spread. A person with HBV can spread it to their baby during childbirth. Other ways in which HBV may be transmitted include: Sharing medical equipment, whether at home or in a hospital setting, with a person who has an HBV infection Sharing syringes with a person who has hepatitis B, such as during injection drug use or at-home piercing or tattooing Sharing personal items, such as razors or toothbrushes, with someone who has hepatitis B Coming into contact with the sores or blood of a person who has hepatitis B Hepatitis B vaccination is recommended regardless of whether a person has any risk factors. If you have an increased risk of contracting HBV, it's especially important to protect yourself with the hepatitis B vaccine. Some of the risk factors for hepatitis B include: Living with someone who has hepatitis B Having a sexual partner who has hepatitis B Having multiple sexual partners Being a man who has sex with men Working in a healthcare facility, assisted living facility, prison, or care facility for people with developmental disabilities Having a human immunodeficiency virus (HIV) infection Injection drug use Having diabetes Traveling to parts of the world with high rates of hepatitis B Being on kidney dialysis Having hepatitis C Who Should Not Receive the Hepatitis B Vaccine? Talk to your healthcare provider before getting the hepatitis B vaccine if:You have had a severe allergic reaction to the hepatitis B vaccine or any of its ingredients in the past. You have had an allergic reaction to yeast in the past.You are moderately or severely ill.You are currently taking immunosuppressive medications.In addition, pregnant people should not receive the Heplisav-B or PreHevbrio vaccines until more safety information is available. Vaccination Side Effects Most side effects from the hepatitis B vaccine are mild and resolve on their own within a few days. Common side effects include: FeverSwelling, pain, and/or redness of skin at the injection site HeadacheNausea and vomiting Very rarely, the hepatitis B vaccine can cause a severe allergic reaction. Symptoms may include: Swelling of the face, throat, or tongue Muscle weakness Difficulty breathing Rapid heart rate Hives Dizziness or light-headedness Seek immediate medical help if you have any signs of an allergic reaction after receiving the hepatitis B vaccine. How Do Vaccines Work, Exactly? Summary Hepatitis B is a viral infection that causes inflammation of the liver. In rare cases, hepatitis B can lead to serious medical problems like liver cancer or liver failure. The hepatitis B vaccine offers effective protection against HBV for infants, children, adolescents, and adults. Infants should receive one dose of the vaccine just after birth, followed by a second dose at 1–2 months and the third dose at 6–18 months. Adults ages 19–59 should receive the hepatitis B vaccine in a two- or three-dose series, typically over the span of six months. Adults ages 60 and older who have a high risk of contracting hepatitis B should also receive the vaccine. A Word From Verywell The hepatitis B vaccine is an effective, safe way to protect yourself and others from HBV infection and related complications. Talk to your healthcare provider if you have any concerns about potential side effects or complications from the Hep B vaccine. Frequently Asked Questions How often do you need to get the hepatitis B vaccine? Babies should receive one dose of the hep B vaccine just after birth, as well as second and third doses at 1–2 and 6–18 months. Adults under 60 who did not previously complete vaccination should typically get a two- or three-dose series over the course of six months. People with certain risk factors, such as people on hemodialysis, may need additional doses. When do you need a hepatitis B booster? Most healthy adults who are not high-risk for hepatitis B and have previously been vaccinated don’t need a booster dose. If you are immunocompromised, your healthcare provider may recommend that you receive an additional dose. People who have at least one hepatitis B risk factor should also talk to their healthcare provider about getting a booster shot. Are there any risks associated with getting the hepatitis B vaccine? Most people experience only mild side effects from the hep B vaccine. Common side effects include local pain at the injection site, headache, and fever. Very rarely, more serious adverse reactions—such as a severe allergic reaction—may occur. 21 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. MedlinePlus. Hepatitis B. Romanò L, Paladini S, Galli C, Raimondo G, Pollicino T, Zanetti AR. Hepatitis B vaccination. Hum Vaccin Immunother. 2015;11(1):53-57. doi:10.4161/hv.34306 Centers for Disease Control and Prevention. Hepatitis B questions and answers for health professionals. Weng MK, Doshani M, Khan MA, et al. Universal hepatitis B vaccination in adults aged 19–59 years: updated recommendations of the Advisory Committee on Immunization Practices — United States, 2022. MMWR Morb Mortal Wkly Rep 2022;71:477–483. doi:10.15585/mmwr.mm7113a1 Centers for Disease Control and Prevention. Hepatitis B vaccines for children. Centers for Disease Control and Prevention. Birth-18 years immunization schedule. Food and Drug Administration. Package insert - Pediarix. Food and Drug Administration. Twinrix. Food and Drug Administration. Vaxelis. Kruszon-Moran D, Paulose-Ram R, Martin CB, Barker L, McQuillan G. Prevalence and trends in hepatitis B virus infection in the United States, 2015–2018. NCHS Data Brief, no 361. Hyattsville, MD: National Center for Health Statistics. 2020. Meireles LC, Marinho RT, Van Damme P. Three decades of hepatitis B control with vaccination. World J Hepatol. 2015;7(18):2127-2132. doi:10.4254/wjh.v7.i18.2127 Food and Drug Administration. Package insert - Engerix-B. Food and Drug Administration. Package insert - Recombivax HB. Food and Drug Administration. Package insert - Heplisav-B. Food and Drug Administration. Package insert - PreHevbrio. Centers for Disease Control and Prevention. Adult immunization schedule by vaccine and age group. Das S, Ramakrishnan K, Behera SK, Ganesapandian M, Xavier AS, Selvarajan S. Hepatitis B vaccine and immunoglobulin: key concepts. J Clin Transl Hepatol. 2019;7(2):165-171. doi:10.14218/JCTH.2018.00037 Centers for Disease Control and Prevention. Hepatitis B - FAQs, statistics, data, & guidelines. National Institute of Diabetes and Digestive and Kidney Diseases. Hepatitis B. Centers for Disease Control and Prevention. Safety information for hepatitis B vaccines. Haykir Solay A, Eser F. High dose hepatitis B vaccine is not effective in patients using immunomodulatory drugs: a pilot study. Hum Vaccin Immunother. 2019;15(5):1177-1182. doi:10.1080/21645515.2019.1574151 By Laura Dorwart Laura Dorwart is a health journalist with particular interests in mental health, pregnancy-related conditions, and disability rights. 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