People at increased risk of contracting hepatitis B should be immunised. The hepatitis B vaccine is also very effective at preventing infection with hepatitis B if you have been at risk from a possible source of infection (for example, a needlestick injury) and you are not immunised. Some people need blood tests to check if they are immune. See your practice nurse if you think you need this vaccine.
Hepatitis B is a disease caused by the hepatitis B virus. The disease mainly affects the liver. However, if you are infected, the virus is present in body fluids such as blood, saliva, semen and vaginal fluid. In the UK it is estimated that about 1 person in 1,000 is infected with the hepatitis B virus. It is much more common in other countries - these include sub-Saharan Africa, most of Asia and the Pacific islands.
If you are infected with the hepatitis B virus, the initial symptoms can range from no symptoms at all to a severe illness. After this acute phase, in a number of cases the virus remains in the body long-term. These people are called carriers. Some carriers do not have any symptoms but can still pass on the virus to other people. About 1 in 4 carriers eventually develop a serious liver disease such as chronic hepatitis, and cirrhosis; in some cases, liver cancer develops after a number of years. See separate leaflet called Hepatitis B for more details of the disease.
All pregnant women in the UK are offered testing for hepatitis B during each pregnancy.
The hepatitis B virus is passed from person to person as a result of:
Anyone who is at increased risk of being infected with the hepatitis B virus should consider being immunised. This includes:
You need three doses of the vaccine for full protection. The second dose is usually given one month after the first dose. The third dose is given five months after the second dose.
One to four months after the third dose you may need to have a blood test. You may need one if you are at risk of infection at work, especially as a healthcare or laboratory worker or if you have certain kidney diseases. Your doctor will be able to advise you if you need a blood test. This checks if you have made antibodies against the hepatitis B virus and are immune.
The schedule is the same for the combined hepatitis A and B vaccine which is also available.
A schedule of giving three doses quicker than usual may be used in some situations. That is, three doses with each dose a month apart. An even quicker schedule is also sometimes used. That is, the second dose given seven days after the first and the third dose given 21 days after the first.
These quicker schedules may be used if you are at very high risk of infection and need to be immune as soon as possible. For example, if you are soon to travel abroad, are new to prison or are sharing needles to inject drugs. However, a more rapid schedule may not be as effective for long-term immunity unless a fourth dose is given 12 months after the first dose. Your doctor will advise on the best schedule for your circumstances.
Side-effects are uncommon. Occasionally, some people develop soreness and redness at the injection site. Rarely, some people develop a mild fever and a flu-like illness for a few days after the injection.
Seek medical attention as soon as possible if you have been at risk from a possible source of infection and you are not immunised. For example, if you have a needlestick injury or have been bitten by someone who may have hepatitis B.
You should have an injection of immunoglobulin as soon as possible. This contains antibodies against the virus and gives short-term protection. You should also start a course of immunisation. The hepatitis B vaccine is very effective at preventing infection if given shortly after contact with hepatitis B. Even if you have had the hepatitis B vaccine and are at risk of infection (for example, by having unprotected sex or sharing contaminated needles), you should ask your doctor for advice, as you may be advised to have a booster vaccine or even an injection of immunoglobulin.
Babies who are born to infected mothers should have an injection of immunoglobulin as soon as possible after they are born. They should also be immunised. The first dose of vaccine is given within the first two days after birth. This is followed by three further doses at 1 month, 2 months and 12 months of age.
The vaccine may be given if you are pregnant or breast-feeding and immunisation against hepatitis B is necessary.
The Great Barn, Godmersham Park, Canterbury, Kent, CT4 7DT
Tel: 01227 738279 Web: www.hepb.org.uk
One of their aims is to raise awareness about the prevention of infection with hepatitis B virus, including the key role of immunisation.