Hep B Vaccine
The Hep B vaccine, the first of many such vaccines
that are routinely administered to US children, is injected into the
newborn shortly after birth. It is given over three doses:
the minimum recommended dosing intervals are 4 weeks between the 1st
and 2nd and 8 weeks between the 2nd and 3rd. The minimum interval
between the 1st and 3rd dose is 16 weeks. The
injection is given in the thigh or the upper arm muscle for
infants whereas the biceps are the preferable injection sites for
Hepatitis B is caused by virus
which attacks the liver. Transmission occurs through several
- unprotected sex with an infected person
- infected mother to baby during
- from workplace accidental exposure to sharps
or other infected items
greatest risk for infection include:
- Contact with chronically infected people
- Diagnosis of an STD
- Healthcare workers
who receive hemodialysis
- Children of infected
- Residence in areas of high infection
The Hep B vaccine is grown in a yeast culture,
so persons who are allergic to yeast should not receive the vaccine.
pregnant, get a blood test
for Hep B. Infants born to infected mothers should be given HBIG
(hepatitis B immune globulin) and vaccinated within 12 hours after
consider the advisability of getting tattoo or body piercing during
pregnacy. If you do choose to do so, ensure the artist uses the
appropriate universal precautions to prevent the transmission of
you work in an at-risk profession, observe barrier precautions and
follow all approved safety precautions for handling and removal of
is The Hep B Vaccine routinely given at birth?
The reasoning for vaccination
at birth is the theory that widespread prevention will occur by
catching every baby early. Additionally, prenatal screening for
maternal infection also reveals those infants truly at risk. According to the World Health Organization position paper
on the Hep B vaccine, "In countries where a lower proportion of HBV
infections are acquired perinatally, the relative contribution of
perinatal HBV infection to the overall disease burden, and the
feasibility and cost-effectiveness of providing vaccination at birth,
should be carefully considered before a decision is made on the optimal
C, Gong Y, Brok J, Boxall EH, Gluud C. Hepatitis B immunisation for
newborn infants of hepatitis B surface antigen-positive mothers. Cochrane
Database of Systematic Reviews
2006, Issue 2. Art. No.:
CD004790. DOI: 10.1002/14651858.CD004790.pub2.
Thimerosal in vaccines: a joint statement of the American Academy of
Pediatrics and the Public Health Service. MMWR 1999;48:563-5.
Academy of Pediatrics. Thimerosal in vaccines: an interim report to
clinicians. AAP News 1999;15:10-2.
Academy of Family Physicians. Policy statement of the American Academy
of Family Physicians on thimerosal in vaccines, July 8, 1999. Available
at http://www.aafp.org/policy/camp/20.html. Accessed September 3, 1999.
Implementation guidance for immunization grantees during the transition
period to vaccines without thimerosal, July 14, 1999. Available at
September 3, 1999.
Advisory Committee on
Immunization Practices. Hepatitis B virus: a comprehensive strategy for
eliminating transmission in the United States through universal
childhood vaccination. MMWR 1991;40(no. RR-13).
Update: recommendations to prevent hepatitis B virus
transmission--United States. MMWR 1999;48:33-4.
Health information for international travel 1999-2000. Atlanta,
Georgia: US Department of Health and Human Services, 1999:98-102.
HS, Coleman PJ, Brown RE, Mast EE, Sheingold SH, Arevalo JA. Prevention
of hepatitis B virus transmission by immunization: an economic analysis
of current recommendations. JAMA 1995;274:1201-8.
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by Catherine Beier, MS, CBE