Hepatitis B – immunisation
Hepatitis B – immunisation
About hepatitis B
Hepatitis B
is a virus which may cause
liver disease
.
Most adults who contract hepatitis B recover completely and do not require ongoing treatment. Children with hepatitis B are more likely to develop chronic hepatitis B (defined as infection that persists for at least 6 months) causing liver disease or
cancer
in later life.
All children should be vaccinated against hepatitis B. Adults at increased risk should be vaccinated against hepatitis B.
In Victoria the hepatitis B vaccine is offered free to all infants, people up to 20 years of age requiring catch-up vaccinations and anyone who is at increased risk of contracting the hepatitis B infection, including Aboriginal and Torres Strait Islander people, men who have sex with men and people living with
HIV
.
Serious side effects or allergic reactions to the vaccines are very rare. If you are concerned about your or your child’s reaction to any vaccine, see your doctor immediately.
Complications of hepatitis B infection in infants and children
Mothers who are living with hepatitis B can pass the virus to their baby at the time of birth if no precautions are taken. Hepatitis B virus can also be spread through exposure of broken skin or mucous membranes to the blood or other body fluids of an infected person.
Babies born to mothers with hepatitis B are recommended a dose of hepatitis B vaccine within 12 hours of birth as well as another medicine called ‘hepatitis B immunoglobulin.’ These 2 injections provide extra protection for babies born to women living with hepatitis B.
Many people living with hepatitis B have no symptoms. Babies and children who are infected with hepatitis B are less likely than adults to have symptoms, but are more likely to develop chronic hepatitis B.
Symptoms of hepatitis B may include:
fever
tiredness
loss of appetite
nausea
vomiting
yellow skin and eyes
aching muscles,
abdominal pain
or joints arthritis.
A child who contracts chronic hepatitis B has an increased risk of developing chronic (long-term) liver disease and cancer later in life. A small proportion of adults who contract the hepatitis B virus develop chronic hepatitis B infection.
Immunisation against hepatitis B
The current Australian
immunisation
program
External Link
provides free hepatitis B vaccine to protect all children against the hepatitis B virus.
A full course of hepatitis B injections must be given for a child to be protected. It is recommended that this course begins within 24 hours of birth with a vaccine against hepatitis B alone. Further doses are routinely given at 2 months (from 6 weeks), 4 months and 6 months of age, as a combination vaccine.
Vaccination is the best protection against hepatitis B infection. In Victoria a free hepatitis B vaccine is available for a number of groups at high risk, including but not limited to Aboriginal and Torres Strait Islander people, refugee and humanitarian entrants, men who have sex with men, people living with HIV, people living with
hepatitis C
and people from high prevalence countries.
The adult course involves 3 doses of the vaccine over 6 months and gives protection to about 95% of people. Once you have had the 3 doses, you can have a blood test to see if you are protected.
Immunisation against hepatitis B for children
Vaccination is the best protection against hepatitis B infection and is recommended for all infants and young children, adolescents and those in high-risk groups. Vaccination can be with a vaccine just against hepatitis B, or provided as a combination vaccine.
Protection against hepatitis B is available free of charge under the
National Immunisation Program
Schedule
External Link
.
In Victoria,
vaccination against hepatitis B is free for all babies and children
including:
babies at birth – vaccinate with hepatitis B vaccine as soon as possible after birth
babies at 2, 4 and 6 months – immunisation in the form of a diphtheria, tetanus, whooping cough, hepatitis B, polio and
Haemophilus influenzae
type b (Hib) vaccine (six-in-one vaccine)
premature babies at 12 months – premature babies born under 32 weeks gestation or under 2,000g birth weight receive a single booster dose
children up to and including 20 years of age.
Immunisation against hepatitis B for people at risk
In Victoria free hepatitis B vaccine is provided for people who are at increased risk, including:
men who have sex with men
people living with HIV
household contacts and sexual partners of people living with hepatitis B
people who inject drugs or are on opioid substitution therapy
people living with hepatitis C
prisoners
people no longer in a custodial setting who commenced, but did not complete, a free vaccine course while in custody
Aboriginal and Torres Strait Islander people
refugee and humanitarian entrants
people born in priority hepatitis B endemic countries who arrived in Australia in the last 10 years – priority countries include China, Philippines, Malaysia, Vietnam, Afghanistan, Thailand, South Korea, Myanmar (Burma), Indonesia, Singapore, Hong Kong, Taiwan and Cambodia
vulnerable citizens – people who have experienced hardship that prevented them from accessing the vaccine earlier. Vulnerable citizens are vaccinated based on an individual assessment by an immunisation provider.
Immunisation is also recommended, but not free, for people who are at increased risk including:
adults on haemodialysis and people with severely impaired renal function who may need dialysis in the future
solid organ and haematopoietic stem cell transplant recipients
immunocompromised adults
people with chronic liver disease or a liver transplant
healthcare or emergency workers or members of a police force or armed forces
workers who come into regular contact with blood or tissue such as funeral workers, embalmers, tattooists
other people who come into regular contact with human tissue, blood or body fluids or used needles or syringes
workers in the sex industry
people who have more than one sexual partner
people with a history of injecting drug use
people with a blood-clotting disorder or who require ongoing transfusions with blood products
residents or staff members at facilities for people with developmental disabilities
travellers to hepatitis B-endemic areas, either long term or for frequent short visits, or undertaking activities that increase their risk of exposure.
If you think you have been exposed to hepatitis B, see a doctor immediately. Your doctor can give you treatment that, in some instances, can greatly reduce your risk of infection with hepatitis B.
Remember that being immunised against hepatitis B does not protect you against HIV, hepatitis C or other diseases spread by blood or bodily fluids. It is important that you take precautions to make sure you are not exposed to these diseases.
Pregnancy and hepatitis B immunisation
Hepatitis B vaccine is not usually recommended for
women who are pregnant
. Speak with your doctor about protecting yourself from hepatitis B if you are not immune to hepatitis B and you are at increased risk.
Pre-immunisation checklist
Before immunisation
, it is important that you tell your immunisation provider if you (or your child):
are unwell (have a temperature over 38.5
°
C)
have had a serious reaction to any vaccine
have had a serious reaction to any component of the vaccine
have had a severe
allergy
to anything
are pregnant or intend to become pregnant.
Side effects of hepatitis B vaccines
Immunisations containing components to protect against hepatitis B (including the six-in-one vaccine) are effective and safe, although all medication can have unwanted
side effects
.
Side effects from the vaccine are uncommon and usually mild, but may include:
localised pain, redness and swelling at the injection site
low-grade temperature (fever)
in children – being unsettled, irritable, tearful, generally unhappy, drowsy and tired
occasionally, an injection-site lump (nodule) that may last many weeks, but for which treatment is not needed.
Managing fever after immunisation
Common side effects following immunisation are usually mild and temporary (occurring in the first few days after vaccination). Specific treatment is not usually required.
There are a few treatment options that can reduce the side effects of the vaccine such as having extra fluids to drink and not overdressing if you have a fever.
Although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be taken – check the label for the correct dose or speak with your pharmacist, especially when giving paracetamol to children.
Managing injection site discomfort
Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for one to 2 days. Paracetamol might be required to ease the discomfort.
Concerns about immunisation side effects
If the side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your child’s condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital.
It is important to seek medical advice if you (or your child) are unwell, as this may be due to other illness, rather than because of the vaccination.
Immunisation side effects may be reported to
SAEFVIC
External Link
, the Victorian vaccine safety and reporting service. Discuss with your immunisation provider how to report adverse events in other states or territories.
Rare side effects after immunisation
There is a very rare risk of a
serious allergic reaction (anaphylaxis)
to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation, in case further treatment is required.
If you think your child may be having a serious allergic reaction and you are no longer at the clinic where they were immunised, take them immediately to your doctor or to the nearest hospital, or call 000 for an ambulance.
Another rare side effect is the hypotonic-hyporesponsive episode (HHE). If they are experiencing HHE, a baby may be:
pale
limp
unresponsive.
This may occur from one to 48 hours following vaccination. The whole episode may last from a few minutes to 36 hours.
If you think your child may be having an HHE episode, take them immediately to your doctor or to the nearest hospital.
Follow-up of children with HHE shows no long-term neurological or other side effects.
Immunisation and HALO
The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.
Check your immunisation
HALO
External Link
.
Talk to your doctor or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary.
Where to get help
In an emergency, always call triple zero (000)
Emergency department of your nearest hospital
Your
GP (doctor)
Pharmacist
Community Pharmacist Pilot
– receive some treatments at a local pharmacy without needing to see a doctor for a prescription in Victoria
LiverWELL
External Link
Tel.
1800 703 003
Local government immunisation service
Maternal and Child Health Line
Tel.
13 22 29
(24 hours, 7 days)
NURSE-ON-CALL
Tel.
1300 60 60 24
– for expert health information and advice (24 hours, 7 days)
Immunisation Unit, Department of Health, Victorian Government Email:
immunisation@health.vic.gov.au
National Immunisation Information
Line
External Link
Tel.
1800 671 811
SAEFVIC
External Link
Tel.
1300 882 924