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Hepatitis B (HepB) - Information for health professionals

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Hepatitis B is an infection of the liver caused by the hepatitis B virus (HBV) which can affect any age group. The Hepatitis B virus (HBV) is carried in the blood and can cause inflammation of the liver and can cause long term damage and occasionally even death. The organism is spread by blood to blood contact, sexual contact, perinatal transmission from mother to child and rarely from bites from an infected person. It has an incubation period of 40 to 160 days. 

Hepatitis B is a notifiable disease

Hepatitis B can become chronic. The definition of chronic Hepatitis B is when Hepatitis B surface antigen (HBsAg) persists in the serum for six months or longer. The risk of developing chronic Hepatitis B depends on the age of when they were infected. 90% of those who are infected immediately before or after birth develop chronic Hepatitis B. It is less frequent in those who are affected as children (the risk in those aged between one and five is between 20 to 50%) and adults, although the risk is higher in those with an impaired immune system. 

20 to 25 percent of those with chronic Hepatitis B can develop progressive liver disease, which may lead to cirrhosis, and are at an increased risk of developing hepatocellular carcinoma.  



There are two classes of products which are available for immunisation against Hepatitis B. Hepatitis B immunoglobulin gives a temporary and passive immunity while waiting for the vaccine to respond and the Hepatitis B vaccine, which gives active immunity. 

The Hepatitis B vaccine does not contain live organisms (it is inactivated) and cannot cause the disease. It is prepared from yeast cells and is manufactured by recombinant DNA technology.   

Hepatitis B vaccination is offered to all babies born after 1 August 2017 as part of the NHS routine vaccination schedule (“6-in-1” vaccine”).  

The Complete Routine Immunisation Schedule includes information about routine and non-routine vaccinations. 

Immunisation for people at high risk of Hepatitis B 

Hepatitis B vaccination in pregnancy 

Hepatitis B infection in pregnant women may result in severe disease for the mother and chronic infection for the baby so it's advised that hepatitis B vaccination should not be withheld from a pregnant woman if she is in a high-risk category. 

There is no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B. As it is an inactivated (killed) vaccine, the risks to the unborn baby are likely to be negligible and the hepatitis B vaccine should be given where there is a definite risk of infection.  

Babies born to mothers with Hepatitis B  

During pregnancy, all women are offered screening for Hepatitis B. Babies born to mothers who, following screening, are found to be chronically infected with hepatitis B virus (HBV) or who have had acute hepatitis B during pregnancy are at risk of becoming infected with HBV. In addition to the routine hepatitis B vaccinations, babies born to mothers infected with hepatitis B need to be given extra doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age. 

Some mothers infected with hepatitis B are considered especially high-risk because they are highly infectious. Babies born to these high-risk mothers should receive an injection of Hepatitis B immunoglobulin (HBIG) at birth. HBIG is made from blood and contains antibodies to hepatitis B. It gives fast protection but is not long lasting. They will also need a Hepatitis B vaccination to give them the longer-term protection.  

All babies born to mothers infected with hepatitis B should have a blood test at 12 months of age to check if they have become infected with hepatitis B. 

Hepatitis B vaccine for those considered ‘at-risk’ 

All those in high risk groups are also offered the hepatitis B vaccine. Some of these groups include individuals who: 

  • have chronic kidney disease (CKD stage 4 and 5, including haemodialysis) require Hepatitis B  

  • have chronic liver disease (for instance those who have severe liver disease, such as cirrhosis of any cause, or have milder liver disease and may share risk factors for acquiring hepatitis B infection, such as individuals with chronic hepatitis C) 

  • receive regular blood or blood products (for example individuals with haemophilia, thalassaemia, or other chronic anaemia) or carers who administer such products 

  • inject drugs  

  • are sexual partners, children, or other close family or household contacts of people who inject drugs (PWID) 

  • change sexual partners frequently, are men who have sex with men (MSM) or commercial sex workers 

  • are household, close family or sexual contacts of an individual with hepatitis B infection  

  • are members of a family adopting children from countries with a high or intermediate prevalence of hepatitis B 

  • are, or are close family member of or share a household with short-term foster carers who receive emergency placements 

  • are, or are close family member of or share a household with permanent foster carers who accept a child known to be hepatitis B infected 

  • are inmates of custodial institutions in the UK, including those on remand 

  • are resident in accommodation for those with learning disabilities 

  • are adults or children attending day care, schools, and centres for those with learning disabilities and based on local risk assessment, are at risk of percutaneous exposure (such as biting or being bitten) on a regular basis 

  • are solely at an occupational risk of hepatitis B exposure  

  • are travelling to high-risk countries  


Summary of product characteristics 

The Hepatitis B vaccine is given as a single or combined product:  

An appropriate vaccine product should be selected for the patient.  

Schedule guidance in the Green Book chapter 18  supersedes the SmPC. 

The Complete Routine Immunisation Schedule (PDF) includes information about routine and non-routine vaccinations. 



Vaccination programme recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) and Welsh Government policy can be found at the links below. 

Joint Committee on Vaccination and Immunisation - GOV.UK (read JCVI publications and statements:  search e.g., Hepatitis B) 

Welsh Health Circulars and Welsh Government letters 

January 2023. Eliminating hepatitis (B and C) as a public health threat: actions for 2022 to 2023 and 2023 to 2024 (WHC/2023/001) 

October 2017. Attaining the WHO targets for eliminating hepatitis (B and C) as a significant threat to public health.  

2017. Introduction of the hexavalent (“6 in 1”) vaccine including hepatitis B into the routine immunisation schedule for babies born on or after 1 August 2017. 

2017. Change of vaccine for the routine primary infant immunisation. 


Training resources and events 

Online courses and training materials about a number of vaccines and diseases can be accessed via the E-learning page. 

Further immunisation training information and resources are provided on the Training Resources and Events page. 


Clinical resources and information 

Patient group directions (PGDs) and protocols 

PGD templates for vaccines can be found on the Patient group directions (PGDs) and protocols page.  


Further clinical resources and information 


Data and surveillance 

Vaccination surveillance information can be found on the pages below: 

If considering this vaccine as a part of travel health protection, then see the Public Health Wales Travel Vaccination page