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Hepatitis B vaccine

What is hepatitis B?

Hepatitis B is a disease caused by a virus. The hepatitis B virus infects the liver.

Half of all people with hepatitis B do not feel sick at all. But they can still pass the disease to others. Some will become carriers and have the virus in their blood and other body fluids (like semen) for the rest of their lives.

In other cases, hepatitis B makes people very sick. These people can become sick with fever, fatigue, loss of appetite, and yellow skin and eyes (jaundice). The illness can last for weeks or months. Most people will get better and become immune (protected from the illness) for life. A small number become carriers. The younger you are when you become infected, the more likely you are to become infected for life.

Carriers can pass the virus to other people and are at high risk for getting cirrhosis (liver disease), liver failure, and cancer of the liver. Some carriers need a liver transplant and others die of their liver disease.

There is no cure for hepatitis B, but treatment can sometimes decrease the amount of virus in the blood and body secretions. It can also prevent some of the other problems caused by the disease.

How common is hepatitis B?

In Canada, there are usually less than 1,000 new infections per year. Most cases come from sharing needles or having sex with a carrier. Lots of babies used to be born with hepatitis B, but this doesn’t happen very often anymore. Pregnant women are tested for the disease. Babies whose mothers have the disease get the vaccine and hepatitis B immune globulin (a shot with a large amount of antibodies) soon after they are born.

In other parts of the world, hepatitis B is more common than in Canada and still infects many babies. If you travel to China, southeast Asia or some parts of Africa, you may be at higher risk, especially if you have sex with local people, use drugs with a needle, or need a blood transfusion.

How can you tell if you have hepatitis B?

Your doctor will have to do a blood test.

How is hepatitis B spread?

Hepatitis B virus does not spread in the air. You cannot breathe it in like a cold or flu.

It spreads from person to person through body fluids. The kinds of body fluids that spread hepatitis B are:

  • blood,
  • breast milk,
  • semen (the liquid that comes from a man’s penis during sex), and
  • fluids in a woman’s vagina.

It can spread:

  • through direct contact with blood or blood-tinged fluids.
  • during sexual intercourse.
  • from sharing needles during drug use
  • from infected needles in a tattoo shop.
  • when you have your ears or other parts of your body pierced.
  • from a mother to her baby when she is pregnant or when giving birth.
  • from sharing toothbrushes or razors (when blood has been in touch with the toothbrush or razor).

What can you do to stop the spread of hepatitis B?

  • Get the hepatitis B shot.
  • If you are pregnant, have a blood test to see if you have hepatitis B.

In a child care, school, or home setting:

  • If someone in your house has hepatitis B, get the shot.
  • If you know someone who has hepatitis B, be careful not to touch their blood if they are bleeding.
  • Wear gloves to clean up any spills of body fluid.

During sexual intercourse:

  • Always wear a condom when you have sex.

If you are drug user:

  • Don’t share needles. Always use a clean needle.

Who should get the vaccine?

  • Newborns of mothers who have hepatitis B.
  • If your child attends daycare, talk to your doctor about whether she should get the hepatitis B vaccine
  • All children before or in early adolescence. In some provinces and territories it is given during infancy. To find out when your province offers the vaccine visit:
  • People who are travelling to countries where there is a risk of hepatitis B.
  • People who are at higher risk of contact with blood such as:
    • health care workers,
    • people on hemodialysis (treatment for kidney disease),
    • babies with mothers who have hepatitis B and,
    • children under 7 years of age who have immigrated to Canada from areas with high rates of hepatitis B.

Talk to your doctor to find out if you are at risk.

How do you get the vaccine?

The hepatitis B vaccine is available alone or in combination with the hepatitis A vaccine. The combined vaccine is good for people who are travelling and for school immunization programs. Children under 1 year of age should not be given the combination vaccine.

  • A nurse or doctor will give you a needle in your arm or leg.
  • It is most common to get the vaccine in 3 doses over a 6-month period. The second dose is given 1 month after the first. The third is given 5 months after the second.
  • When you get the vaccine and how many shots you get depends on where you live. Speak to your doctor about what is right for you.

How safe is the vaccine?

  • It is very safe.
  • With any vaccine, there may be some redness, swelling or pain where the needle went into the arm or leg.

Who should not get the vaccine?

  • People who have had an allergic reaction to a previous dose of the vaccine should not get it again. An allergic reaction includes: swelling of the face or lips, difficulty breathing or if your blood pressure drops.

For complete information on vaccinations in Canada, read Your Child's Best Shot: A Parent's Guide to Vaccination.

Reviewed by the following CPS committees:
Infectious Diseases and Immunization Committee

Last Updated: November 2008