Many of the more than 226,000 Australians living with lifelong Hepatitis B infections are unaware they have contracted the virus, which can be prevented through immunisation. To prevent children growing up with the risk of infection, our National Immunisation Program introduced a funded vaccine series, starting with newborns having their first dose of Hepatitis b vaccine in the first 24 hours of life or within the first 7 days. Adults too are recommended to receive hepatitis B vaccinations for a number of reasons such as work, travel and underlying medical conditions.
What is Hepatitis B?
Hepatitis B is a vaccine preventable viral infection of the liver caused by the hepatitis B virus (HBV). In infected individuals the virus is present in body fluids such as blood, semen and vaginal secretions and is usually transmitted through sexual contact, intravenous drug use, prolonged close contact with infected individuals or from an infected mother to her baby during birth. HBV can also be transmitted through accidental needle-stick injuries, tattooing, ear-piercing, nicks from infected razors, acupuncture and dental procedures but it is not transmitted through contaminated food or water. In countries with high rates of hepatitis B infections and low rates of hepatitis B immunisations, it is relatively common for infected infants and young children to pass the virus on to their peers. Not all people newly infected with HBV have symptoms. For many hepatitis B is a short-term illness, but for others, particularly those who are infected early in life, it can become a long-term, chronic infection that can lead to serious, even life-threatening health issues like cirrhosis or liver cancer. The best way to prevent hepatitis B is to be vaccinated.
What are the symptoms?
HBV has a long incubation period, averaging 10 weeks (range of 2 to 6 months), and the infection may not present any symptoms at all. Of those who develop an acute illness, symptoms include gradually increasing fatigue, loss of appetite, nausea and pain in the right upper abdomen. There may also be a rash, pain in the joints and a developing yellow discolouration of the skin (jaundice) and darkening of the urine. As with Hepatitis A, mild or asymptomatic infections occur, but less frequently. One important difference with Hep B is that 10% of adults and 30% of children who contract HBV will become chronic carriers: this means they will recover but will always remain capable of transmitting the disease. Some carriers will develop chronic hepatitis that can later lead to liver failure or liver cancer. In a small number of cases, HBV infection results in rapid liver failure and death.
Where is it found?
Hepatitis B prevalence is highest among some sub-Saharan African, East and Southeast Asian, and Pacific island populations but can also be found in high numbers in Mediterranean countries, parts of Eastern Europe, Africa, and Central and South America. It is important to note that although there is a higher risk of infection in certain countries or regions, Hepatitis B is global.
Risk to travellers
Most individuals have some degree of risk of contracting Hepatitis B. High-risk behaviour includes:
- Unprotected sex.
- Multiple sexual partners or encounters with sex workers.
- Intravenous drug use.
- Exposure to blood products or needles (i.e. dental work, tattoos, body piercing, acupuncture).
- Living/travelling in regions where there is a high number of HBV carriers. This risk is accentuated for travellers engaging in adventure-style activities, where the risk of injury is higher.
- Health care and aid workers.
How is Hepatitis B transmitted?
In infected individuals, the HBV virus is present in body fluids such as blood, semen and vaginal secretions and is usually transmitted through sexual contact, intravenous drug use, prolonged close contact with infected individuals or from an infected mother to her baby during birth. HBV can be transmitted through accidental needle-stick injuries, tattooing, ear-piercing, nicks from infected razors, acupuncture and dental procedures. It is not transmitted through contaminated food or water. In countries with high rates of hepatitis B infections and low rates of hepatitis B immunisations, it is relatively common for infected infants and young children to pass the virus on to their peers. The virus can survive a week or more in the environment, retaining its ability to infect anyone who is exposed but not immunised.
Who Needs Hepatitis B Vaccinations?
Many individuals from all walks of life can benefit from Hepatitis B vaccinations. The various recommendations for babies, young children, adolescents, to adults (including pregnant women) can be found below.
Pregnant Women
While the Hepatitis B vaccine is not routinely recommended for pregnant or breastfeeding women, the World Health Organization states that pregnancy and breastfeeding are not contraindications for hepatitis B vaccination. The best advice is to get the timing right by ensuring all the recommended vaccinations and boosters have been administered when planning pregnancy.
Adults
Adults - travellers, those with an occupational risk or underlying medical conditions should receive a 3-dose course of hepatitis B–containing vaccine. In most cases, no booster doses are required, however we recommend this is fully discussed with your doctor.
Babies
Infants are recommended to receive 4 doses of hepatitis B vaccine:
- A single dose of monovalent paediatric formulation hepatitis B vaccine at birth
- 3 doses of a paediatric hepatitis B–containing vaccine at 2, 4 and 6 months of age (usually provided as DTPa-hepB-IPV-Hib [diphtheria-tetanus-acellular pertussis, hepatitis B, inactivated poliovirus, Haemophilus influenzae type b]).
Infants, children and adolescents
Infants and children <10 years of age
- Catch-up of the birth dose is not necessary. If an infant has not received a birth dose before they are 7 days of age, they should receive the recommended 3-dose course of a hepatitis B–containing vaccine.
Adolescents
- Adolescents not vaccinated during childhood should receive a 3-dose course of a hepatitis B–containing vaccine.
Our Recommendation
Travelvax urges travellers to take common sense precautions to avoid exposure to the Hepatitis B virus. The risk of infection is increased during travel and any accidents or injuries may require medical treatment and in many third world countries, blood transfusions may not be adequately screened for Hepatitis (as well as STIs and HIV-AIDS); needles may also be re-used.
So, the hepatitis B vaccine recommendations for travellers are to obtain hepatitis B vaccinations if they are visiting regions of intermediate or high endemicity, and either:
- travelling for a long time, or taking short, frequent trips, or
- likely to participate in activities that increase their risk of exposure to hepatitis B virus
Hepatitis B Vaccination
Australian children are vaccinated against Hepatitis B as part of the National Immunisation Program, but for adults the best way to ensure protection when visiting countries at higher risk of Hepatitis B is through vaccination. There are two Hep B vaccine types -
- Monovalent vaccines
- Combined vaccine with Hepatitis A*
Read more in the Australian Immunisation Handbook.
Hepatitis B Vaccine Cost Australia
Hepatitis B vaccination costs vary. For some people the vaccine is funded: babies, young adults under 20 years of age, and for people who live with someone infected with hepatitis B.
To obtain the vaccine, you will usually pay for the consultation, unless your doctor is a bulk-bill provider.
Schedule
Standard 3-dose schedule
The 3-dose early childhood schedule of DTPa-hepB-Hib-IPV (diphtheria-tetanus-acellular pertussis, hepatitis B, inactivated poliovirus, Haemophilus influenzae type b) is given at 2, 4 and 6 months of age.
The adult-formulation hepatitis B vaccine should be given in a 3-dose schedule on day 0 (day of vaccination) with the 2nd dose one month after 1st and the 3rd dose administered 6 months after 1st dose.
There is an accelerated hepatitis B vaccination schedule for people with imminent risk of exposure which should be discussed with your healthcare provider.
Alternate schedules for schoolchildren are available. Consult a medical practitioner for details.
Contraindications: Hepatitis B vaccine should not be administered to individuals who have previously experienced a serious reaction to this vaccine or those who are known to be hypersensitive to any of the vaccine components.
Level of Protection
Greater than 90% immunity after three doses.
Immunity is life-long. (Australian immunisation experts do not recommend testing for immunity unless in a high-risk group).
Possible Side Effects
- Usually infrequent and mild.
- Redness, swelling, a hard lump or bruising around the injection site.
- Feeling unwell, headache, dizziness, tiredness.
- Muscle aches and pains.
- Coughing, sore throat, runny nose, mild fever, swollen glands, chills or sweating.
As with all vaccines, there is a small risk of allergic reaction.
Where can I get a Hepatitis B vaccination Near Me?
If you require vaccination against Hepatitis B, head to a Travelvax clinic near you. Staffed by health professionals who have access to state-of-the-art equipment, we can help keep you safe on your next trip.