Topic: Hepatitis B and Immunisation
Description
Hepatitis B is an infection caused by the hepatitis B virus. The virus can cause either acute (short-lived) or chronic (long term) liver disease.
The disease course of hepatitis B is very complex. The main predictor of disease course is age of infection:
- infants infected with hepatitis B rarely experience symptoms of acute infection, but 90% will develop chronic or lifelong infection
- children infected with hepatitis B rarely experience symptoms of acute infection, but 30% will develop chronic or lifelong infection
- adults or adolescents infected with hepatitis B commonly experience symptoms of acute infection, however less than 5% develop chronic or lifelong infection.
Some people can develop hepatitis B disease and not be aware they are infected. More than half of those infected with hepatitis B show few or no symptoms. This can be a risk as they may transmit the virus to others without knowing it.
The hepatitis B virus lives in blood or other body fluids. It is spread through blood-to-blood contact with an infected person, e.g. sharing needles or syringes, coming into contact with inadequately sterilised instruments (such as those used for tattooing and body piercing) and sexual contact. Babies with infected mothers are also at very high risk of being infected with hepatitis B at birth.
Practical Advice
Immunisation
Immunisation against hepatitis B is recommended as part of the National Immunisation Program Schedule and the vaccine is available free for:
- babies at birth, with further doses at 2, 4 and 6 months of age
- Year 8 students in Queensland who have not already received a course of hepatitis B vaccinations.
The hepatitis B vaccine for children is given as one injection combined with other childhood vaccines.
For adolescents who have not received hepatitis B immunisation, the National Health and Medical Research Council (NHMRC) recommends two doses of hepatitis B vaccine, given four to six months apart. In Queensland, Year 8 students are offered immunisation through their school as part of the School Based Vaccination Program. No booster doses are required. See the Queensland Health Immunisation Website for more information on the School Based Vaccination Program.
The vaccine is also funded for susceptible people in the following groups:
- household contacts of people with acute and chronic hepatitis B
- sexual partners of people with acute and chronic hepatitis B
- injecting drug users
- people with hepatitis C or chronic liver disease
- Aboriginal and Torres Strait Islander people up to the age of 18 years
- people born in countries with estimated prevalence of HBsAg carriage being equal or great than 5%, up to the age of 18 years.
The vaccine is also recommended (but not funded) for other people at high risk of exposure to the disease:
- haemodialysis patients, HIV positive individuals and other adults with impaired immunity
- recipients of certain blood products
- residents and staff of facilities for people with intellectual disabilities
- those adopting children from overseas
- liver transplant recipients
- inmates and staff of long-term correctional facilities
- healthcare workers including ambulance personnel and dentists
- people travelling to countries where hepatitis B is common
- police, emergency services staff, members of the armed forces if assigned to duties which may involve exposure
- others at risk including embalmers, tattooists, body piercers and sex industry workers.
It is important that all recommended doses of the vaccine are received at the recommended times, if it is to be fully effective.
Possible side effects of the vaccine
Like all medications, vaccines may have side effects. Most side effects are minor, last a short time and do not lead to any long-term problems.
Possible side effects may include soreness where the injection was given, mild fever, tiredness, and aching muscles. More serious side effects are extremely rare and can include severe allergic reactions.
Contact your immunisation provider if you or your child has a reaction following vaccination which you consider serious or unexpected.
Pre-vaccination checklist
This checklist helps your doctor/nurse decide about vaccinating you or your child.
Please tell your doctor/nurse if the person about to be vaccinated:
- is unwell today
- has a disease which lowers immunity (e.g. leukaemia, cancer, HIV/AIDS) or is having treatment which lowers immunity (e.g. oral steroid medicines such as cortisone and prednisone, radiotherapy, chemotherapy)
- has had a severe reaction following any vaccine
- has any severe allergies (to anything)
- has had any vaccine in the past month
- has had an injection of immunoglobulin, or received any blood products or a whole blood transfusion within the past year
- is pregnant
- has a past history of Guillain-Barre syndrome
- was a preterm infant
- has a chronic illness
- has a bleeding disorder.
A different vaccine schedule may be recommended if the person to be vaccinated:
- identifies as an Aboriginal or Torres Strait Islander
- does not have a functioning spleen
- is planning a pregnancy or anticipating parenthood
- is a parent, grandparent or carer of a newborn
- lives with someone who has a disease which lowers immunity (eg. leukaemia, cancer, HIV/AIDS), or lives with someone who is having treatment which lowers immunity (eg. oral steroid medicines such as cortisone and prednisone, radiotherapy, chemotherapy).
Care after vaccination
For redness or swelling at the injection site, apply a cold compress.
- To lower temperature or relieve discomfort, paracetamol may be given.
- If fever persists, consult your doctor.
- If any reaction occurs that you consider serious or unexpected, seek medical advice.
- Contact the service provider if you or your child has a reaction following vaccination.
Where can I be immunised?
You can be immunised at your local doctor or medical centre. Some councils, community child health and community health centres hold free immunisation clinics. Check with them for details.
Other Resources
For further information please contact:
- your doctor
- your nearest public health unit
- 13HEALTH (13 43 25 84)
- Immunise Australia National Infoline: 1800 671 811.
Immunise Australia
A website about childhood immunisation produced by the Australian Department of Health and Ageing.
Commonwealth Department of Health and Ageing
Information about communicable diseases including vaccine preventable diseases.
Australian Childhood Immunisation Register (ACIR)
A website about the Australian Childhood Immunisation Register (ACIR), produced by Medicare Australia.
Heymann D, (ed). 2008. Control of Communicable Diseases Manual (19th ed). Washington, DC: American Public Health Association.
Related Content
Communicable Diseases factsheet - Hepatitis B
Queensland Health Immunisation Website
National Health and Medical Research Council, 2008. The Australian Immunisation Handbook (9th Ed).
Last updated: 4th April, 2012
Review Date: 2nd April, 2013
