Hep B vaccine — How often?

Dear Alice,

My adopted son has hepatitis B and D. My family had been vaccinated (Heptavax) prior to the adoption. I have received contradictory information on how often we must be administered the six month, three-shot series of Heptavax vaccinations: I've heard both every five years and every ten years. Can you tell me which — if either — is accurate?

Dad of 3

Dear Dad of 3,

Adoption is a wonderful way to bring someone into your family. Although your son is experiencing the virus, the steps you have taken will offer protection for the rest of your family. The Hepatitis B vaccine is given in three shots. The first shot can be given at any time and the second injection is given at least one month after the first. The third (and last, whew!) injection is given six months after the first injection. According to the Centers for Disease Control and Prevention (CDC), booster shots of the Hep B vaccine are not necessary (FYI, Heptavax-B was discontinued in the United States in 1990, but the currently used Hep B vaccine, Energix-B, is considered to be safe and effective). 

So why all the needles? Hep B is a highly communicable liver infection caused by the hepatitis B virus (HBV). For more information on Hep B and how it is spread, be sure to check out Hepatitis B lowdown in the Go Ask Alice! archives. Hep B is one of six strains of hepatitis — there's also Hep A, C, D, E, and G. The various strains differ in the way they can be transmitted and in severity. Nevertheless, the Hep B vaccine also protects against Hep D infection, which only occurs when a person is already infected with Hepatitis B, according to the Hepatitis B Foundation. Hepatitis A and B are the only strains for which there are vaccines available.

Most people who are infected with Hep B as adults fully recover, but infants and children may be more susceptible to chronic Hepatitis B infection. A chronic infection may result in liver failure, liver cancer, or cirrhosis. Most infants and children with Hep B never develop symptoms, however Hep B symptoms may include:

  • Loss of appetite
  • Nausea and vomiting
  • Weakness and fatigue
  • Abdominal pain, especially around your liver
  • Dark urine
  • Yellowing of your skin and the whites of your eyes (jaundice)
  • Joint pain
    List adapted from Hepatitis B by the Mayo Clinic.

For children or adults with chronic Hep B, lifelong monitoring of liver function and screening for liver cancer may be necessary. Treatment for chronic Hep B typically includes four types of therapies: Interferon, Lamivudine (Epir-HBV), Adefovir dipivoxil (Hepsera), and Entecavir (Baraclude). Beyond treatment, the following prevention tips may be recommended by a healthcare provider for individuals with Hep B:

  • Avoid or limit alcohol consumption
  • Avoid medications that may cause liver damage, e.g. drugs with acetaminophen
  • Eat a healthy diet (fresh fruits and veggies, whole grains, and lean protein)
  • Exercise regularly
  • Get enough sleep

If you, or your children, are experiencing any of these symptoms, you may want to talk to your primary health care provider. You may also want to visit the American Liver Foundation website for more information.

Here's hoping this covers the a, b and c's of the Hepatitis B vaccine,

Last updated Jul 08, 2015
Originally published Sep 26, 1996

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