Hepatitis B Vaccine: Who Should Get It, Safety, Side Effects, Cost
Infectious DiseasesHepatitis B
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Hepatitis B Vaccine: What You Need to Know

Hepatitis B Vaccine: What You Need to Know
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Published on January 8, 2025
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The hepatitis B vaccine protects against liver infection caused by the hepatitis B virus (HBV). This virus is highly contagious and can spread through exposure to blood, semen, and other bodily fluids.

While most people will have hepatitis B for a short period of time before their immune system eliminates it, hepatitis B can sometimes become long-lasting (chronic). If not properly managed, chronic hepatitis B has the potential to lead to liver inflammation, liver disease (cirrhosis), and liver cancer.

While there is no cure for chronic hepatitis B, there are treatments to help manage the condition as well as a safe and effective vaccine.

Overview

What Is the Hepatitis B Vaccine?

The hepatitis B vaccine is made in a lab using yeast cells to produce many copies of a protein that sits on the surface of the hepatitis B virus. The vaccine prompts a person’s immune system to create antibodies that can recognize and defend against the hepatitis B virus should there be a future exposure.

Hepatitis B vaccination usually requires several doses (shots), all of which are needed for full protection.

Who Should Get the Hepatitis B Vaccine?

The Centers for Disease Control and Prevention (CDC) recommends that nearly everyone get the hepatitis B vaccine series, including:

  • All infants
  • All children and adolescents younger than 19 who have not been vaccinated
  • Adults ages 19 to 59
  • Adults ages 60 and older at higher risk for hepatitis B
Anyone can get hepatitis B, but those at higher risk include:

  • Infants born to people with hepatitis B
  • People born in certain countries where hepatitis B is common
  • People born in the United States who were not vaccinated against hepatitis B and whose parents are from countries where hepatitis B rates are high
  • People who have hepatitis C
  • People who have sexually transmitted infections, such as HIV
  • People who are on dialysis
  • People who have liver damage or inflammation
  • People who have been in jail or prison
  • People who inject drugs or share needles, syringes, or other drug equipment
  • Sex partners of people who have hepatitis B
  • Men who have sex with men
  • People who live with someone who has hepatitis B
  • Healthcare and public safety workers who are exposed to blood on the job
The CDC recommends the hepatitis B vaccine for anyone who is pregnant and has not previously received it. A pregnant person who has hepatitis B or is a carrier of the hepatitis B virus can pass it to their baby during childbirth.

Who Shouldn’t Get the Hepatitis B Vaccine?

Most people can safely receive the hepatitis B vaccine, but there are a few exceptions:

  • People with severe allergies to yeast: Since the vaccine is produced using yeast cells, anyone with a severe yeast allergy should avoid it.
  • People with a serious allergic reaction to a previous dose of the hepatitis B vaccine: If you had an allergic reaction to the vaccine in the past, talk to your doctor about whether you should be vaccinated again.
  • People who are sick: If you are moderately or severely ill you should wait until you recover before getting the vaccine. If you have a minor issue like a cold, it’s okay to get a vaccine dose.

What Are the Different Types of Hepatitis B Vaccine?

There are seven vaccines available in the United States that protect against hepatitis B:

Hepatitis B–Only Vaccines

  • Engerix-B for infants, children, and adults
  • Heplisav-B for adults
  • PreHevbrio for adults
  • Recombivax HB for infants, children, and adults

Combination Vaccines

  • Pediarix for infants and young children: protects against diphtheria, tetanus, whooping cough, and polio as well as hepatitis B
  • Vaxelis for infants and young children: protects against diphtheria, tetanus, whooping cough, polio, and Hib disease as well as hepatitis B
  • Twinrix for adults: protects against both hepatitis A and hepatitis B

When to Get the Hepatitis B Vaccine

Infants and Children Vaccination Schedule

For people 18 years old and younger it’s recommended that a vaccination series begins at birth. Typically, a three-dose series involves a shot at age 0, 1 to 2 months, and 6 to 18 months.

Infants who don’t receive a birth dose should begin the series as soon as possible.

Infants born to a mother who has hepatitis B should receive the birth dose of the vaccine along with hepatitis B immune globulin (HBIG) in separate arms within 12 hours of birth.

Catch-up vaccinations in children who never received the vaccine as an infant typically involve a three-dose series. Adolescents ages 11 to 15 years old may get an alternative two-dose schedule with at least four months between doses with adult formulation Recombivax HB only.

Adult Vaccination Schedule

Adults ages 19 and older need to complete a series of two, three, or four shots, depending on the brand of vaccine.

  • A two-dose series of Heplisav-B used at least four weeks apart
  • A three-dose series of Engerix-B, PreHevbrio, or Recombivax HB at 0, 1, and 6 months (minimum intervals: dose one to dose two is 4 weeks; dose two to dose three is 8 weeks; dose one to dose three is 16 weeks)
  • A three-dose series of HepA-HepB (Twinrix at 0, 1, 6 months [minimum intervals: dose one to dose two is 4 weeks; dose two to dose three is 5 months])
  • A four-dose series of HepA-HepB (Twinrix) accelerated schedule of three doses at 0, 7, and 21 to 30 days, followed by a booster dose at 12 months

People in special situations, such as people traveling on short notice or emergency responders to disaster areas, may be able to receive the hepatitis B vaccine on an accelerated schedule.

Heplisav-B and PreHevbrio are not recommended in pregnancy due to lack of safety data in pregnant persons.

How Well Does the Hepatitis B Vaccine Work?

The hepatitis B vaccine is highly effective. After completing the full vaccination series, a person will be from 80 to 100 percent protected against hepatitis B.

Anyone who does not respond to initial vaccination should talk to a healthcare provider about whether to get a second series of shots.

How Long Does the Hepatitis B Vaccine Last?

The hepatitis B vaccine offers long-lasting protection. For most people, immunity lasts at least 20 years, and some studies show it could last a lifetime. However, it’s important to check your immunity status with a blood test if you are at high risk or have specific health concerns.

Do Adults Need a Hepatitis B Booster Shot?

Most adults who received the full series of hepatitis B vaccinations do not need a booster shot as long as their immune system is functioning normally.

Hepatitis B Vaccine Safety and Side Effects

The hepatitis B vaccine is safe. It has been extensively studied and has been used worldwide for decades. It is one of the safest vaccines available.

Like all vaccines, the hepatitis B vaccine can cause side effects, but they are usually mild and go away within a few days. Possible side effects include:

  • Pain, a rash, or swelling at the injection site
  • Mild fever
  • Fatigue or headache

In rare cases, people may experience a severe allergic reaction (anaphylaxis). If you experience any serious issues, such as trouble breathing or swelling of the throat, seek medical attention immediately.

If you have concerns about vaccine side effects or allergies, discuss them with your healthcare provider.

Can the Vaccine Give You Hepatitis B?

The hepatitis B vaccine cannot give you hepatitis B because it does not contain live virus. It is designed to help your immune system recognize and fight the virus if you are exposed in the future.

Hepatitis B Vaccine Cost and Insurance Coverage

Most insurance plans, including Medicaid, cover the full cost of the vaccine. All U.S. health insurance marketplace plans cover certain vaccines, including the hepatitis B vaccine.

Medicare Part B covers hepatitis B shots if you’re at medium to high risk for hepatitis B.

If you don’t have insurance, you may also be able to get the vaccine for free at local health clinics or through programs that provide vaccines to uninsured or underinsured individuals.

Eligible children who aren’t covered by health insurance can get no-cost vaccines through the federal Vaccines for Children (VFC) Program.

If you don’t have insurance or qualify for assistance, the cost of the hepatitis B vaccine will vary depending on where you receive it. At the CVS on-site vaccine clinic, the hepatitis B series costs $172.

Where to Get a Hepatitis B Vaccine Near You

You can get the hepatitis B vaccine at many healthcare providers’ offices, pharmacies, and local health departments. Visit Vaccines.gov to find a location near you.

The Takeaway

  • Hepatitis B is a potentially serious liver disease, but it is preventable with a highly effective vaccine.
  • The vaccine is recommended for everyone, including pregnant women, and is especially important for people at high risk of contracting the virus.
  • The vaccine is safe, with only mild and temporary side effects, and provides long-lasting protection.

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Jane Yoon Scott, MD

Medical Reviewer

Jane Yoon Scott, MD, is an infectious disease physician and an assistant professor of medicine at Emory University in Atlanta. Dr. Scott enjoys connecting with her patients, empowering them to understand and take ownership of their health, and encouraging them to ask questions so that they can make informed and thoughtful decisions.

She graduated with the highest honors from the Georgia Institute of Technology, then received her MD from the Medical College of Georgia. She completed her internal medicine residency training and chief residency at Temple University Hospital, as well as a fellowship in infectious diseases at Emory University. She is board-certified in both internal medicine and infectious diseases.

When she is not seeing patients, Dr. Scott works with neighboring health departments to promote public health, especially to communities that have been historically underserved. She also teaches medical trainees and lectures medical students at the Emory University School of Medicine.

In her free time, Dr. Scott appreciates a good coffee shop, weekend hikes, playing guitar, strolling through cities, sampling restaurants, and traveling to new places.

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Becky Upham has worked throughout the health and wellness world for over 25 years. She's been a race director, a team recruiter for the Leukemia and Lymphoma Society, a salesperson for a major pharmaceutical company, a blogger for Moogfest, a communications manager for Mission Health, a fitness instructor, and a health coach.

Upham majored in English at the University of North Carolina and has a master's in English writing from Hollins University.

Upham enjoys teaching cycling classes, running, reading fiction, and making playlists.

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Resources
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