Vaccine - Hepatitis B

Alternative names
Hepatitis B - vaccine

This immunization protects against Hepatitis B, a serious disease that causes inflammation and damage to the liver and may lead to cirrhosis of the liver, chronic liver disease, and liver cancer.


The Hepatitis B vaccine is one of the recommended childhood immunizations. Hepatitis infection is spread through contact with the blood and body fluids of an infected person. It can also be passed from mother to baby during birth.

About 80,000 children and adults become infected with Hepatitis B each year. Over 10,000 of them need to be hospitalized. In addition, roughly 5,000 deaths in the U.S. per year are attributed to conditions related to chronic infection with the Hepatitis B virus (HBV). Infants and children who become infected with HBV may develop lifelong infection.

Hepatitis B vaccine is given as a series of three injections (shots). The first shot is given to infants shortly after birth. All 3 doses are necessary for the most effective and longest lasting immunity.

If the mother of the infant carries HBV in her blood, the infant needs to receive the first shot shortly after birth. Hepatitis B immune globulin (HBIG) is also given to the baby at that time. The next two shots are given at 2 months of age and then at 6 months of age.

If the mother of the infant does not have evidence of HBV in her blood, the infant may receive the shot anytime prior to leaving the hospital, or it may be deferred until the 4 or 8 week visit to the primary care provider. If given shortly after birth, the second shot is given at 1 to 2 months and the third at 6 months.

For infants who do not receive the first shot until 4 to 8 weeks, the second shot is given at 4 months and the third at 6 to 18 months. In either instance, the 2nd and 3rd shots are given in conjunction with other routine childhood immunizations.

Adolescents who have not been vaccinated should begin the Hepatitis B vaccine series at the earliest possible date.

Most infants who receive the HBV vaccine experience no associated problems. Others may have minor problems, such as soreness and redness at the injection site or a mild fever. Serious problems associated with receiving the immunization are rare and are mainly related to allergic reactions to a component of the vaccine.


  • If the child is ill with something more serious than a cold, immunizations may be delayed.  
  • If the child has a severe allergic reaction to baker’s yeast, they should not have the vaccine.  
  • If severe allergic reaction or anaphylaxis occurs after an injection of the HBV vaccine, no further HBV immunization should be given to the child.

Watch for and be familiar with how to treat minor side effects, such as injection site tenderness or low grade fever.


  • uncertain if the Hepatitis B vaccine should be delayed, withheld, or given (according to what schedule) to a specific infant.  
  • moderate or serious adverse effects appear after a HBV injection has been given.  
  • there are any questions or concerns related to the Hepatitis B immunization.

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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