How often should you get the Hep B vaccine?

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. Unfortunately, Heptavax has been discontinued. However, new Hepatitis B (Hep B) vaccines have been engineered and are available for use. For adults, there are two options for vaccine administration. The Hepatitis B vaccine can be given in three shots or two 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 four to six months after the first injection. The second option is to administer two shots that are a month apart. According to the Centers for Disease Control and Prevention (CDC), booster shots of the Hep B vaccine are not necessary, but they also can't hurt! 

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’s 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. Hepatitis A, B, and C all impact liver function; however, 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 Hep B infection. 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 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 can range from minor lifestyle changes, to medication, to surgery to remove the liver or conduct a transplant. Beyond treatment, the following prevention tips may be recommended by a health care 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 well-rounded diet (fresh fruits and veggies, whole grains, and lean protein) 
  • Incorporate movement throughout your week (aim for around 150 minutes of moderate physical activity per week) 
  • Get enough sleep (between seven and nine hours per night) 

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 28, 2023
Originally published Sep 26, 1996

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