Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Hepatitis B vaccine is available for all age groups to prevent HBV infection.

Why should my child get the hepatitis B shot?

The hepatitis B shot:

• Protects your child against hepatitis B, a potentially serious disease
• Protects other people from the disease because children with hepatitis B usually don’t have symptoms, but they often pass the disease to others without anyone knowing they were infected
• Prevents your child from developing liver disease and cancer from hepatitis B
• Keeps your child from missing school or childcare (and keeps you from missing work to care for your sick child)

Is the hepatitis B shot safe?

The hepatitis B vaccine is very safe, and it is effective at preventing hepatitis B. Vaccines, like any medicine, can have side effects. No serious side effects are known to be caused by the hepatitis B vaccine.

What are the side effects?

Most people who get the hepatitis B vaccine will have no side effects at all. When side effects do occur, they are very mild, such as a low fever (less than 101 degrees) or a sore arm from the shot.

The Hepatitis B Vaccine Dose at Birth

It's hard to imagine putting your newborn through the pain of a shot. But a little stick early in life is an important first step to protecting your baby against a deadly disease.

All babies should get the first shot of hepatitis B vaccine before they leave the hospital. This shot acts as a safety net, reducing the risk of getting the disease from moms or family members who may not know they are infected with hepatitis B.

When a mom has hepatitis B, there’s an additional medicine that can help protect the baby against hepatitis B, called the hepatitis B immune globulin (HBIG). HBIG gives a baby’s body a "boost" or extra help to fight the virus as soon as he is born. This shot works best when the baby gets it within the first 12 hours of his life. The baby will also need to complete the full hepatitis B vaccination series for best protection.

What is hepatitis B?

Hepatitis B is a contagious liver disease caused by the hepatitis B virus. When a person is first infected with the virus, he or she can develop an "acute" (short-term) infection. Acute hepatitis B refers to the first 6 months after someone is infected with the hepatitis B virus. This infection can range from a very mild illness with few or no symptoms to a serious condition requiring hospitalization. Some people are able to fight the infection and clear the virus.

For others, the infection remains and is "chronic," or lifelong. Chronic hepatitis B refers to the infection when it remains active instead of getting better after 6 months. Over time, the infection can cause serious health problems, and even liver cancer.

What are the symptoms of hepatitis B?

Infants and young children usually show no symptoms. But, in about 7 out of 10 older children and adults, recent hepatitis B infection causes the following:

• Loss of appetite (not wanting to eat)
• Fever
• Tiredness
• Pain in muscles, joints, and stomach
• Nausea, diarrhea, and vomiting
• Dark urine
• Yellow skin and eyes

These symptoms usually appear 3 or 4 months after being exposed to the virus.

Is it serious?

Hepatitis B can be very serious. Most people with recent hepatitis B may feel sick for a few weeks to several months. In some people, the infection goes away on its own (i.e., resolves without treatment). For other people, the virus infection remains active in their bodies for the rest of their life.

Although people with lifelong hepatitis B usually don’t have symptoms, the virus causes liver damage over time and could lead to liver cancer. For these people, there is no cure, but treatment can help prevent serious problems.

How does hepatitis B spread?

Hepatitis B virus spreads through blood or other body fluids that contain small amounts of blood from an infected person. People can spread the virus even when they have no symptoms.

Babies and children can get hepatitis B in the following ways:

• At birth from their infected mother
• Being bitten by an infected person
• By touching open cuts or sores of an infected person
• Through sharing toothbrushes or other personal items used by an infected person
• From food that was chewed (for a baby) by an infected person

The virus can live on objects for 7 days or more. Even if you don’t see any blood, there could be virus on an object.

Vaccine Information

The vaccination schedule most often used for adults and children has been three intramuscular injections, the second and third administered 1 and 6 months after the first.

What are the different schedules for Hep-B vaccination?

The classical schedule is 0, 1 and 6 months. The vaccine is highly immunogenic and seroconversion rates are greater than 90% after a three dose schedule.

Although the 0-1-6 schedule is the preferred schedule, hepatitis B vaccine schedules are very flexible and there are multiple options for adding the vaccine to existing national immunization schedules without requiring additional visits for immunization. These include:

1. Birth, 6 and 14 weeks
2. 6, 10 and 14 weeks
3. Birth, 6 weeks, 6 months
4. Birth, 6 weeks, 10 weeks, 14 weeks

Sources:

Hepatitis B and the Vaccine (Shot) to Prevent It: Available from: www.cdc.gov

IAP Guidebook on Immunization 2013-14. Available from: www.iapindia.org