Hepatitis B vaccine

The hepatitis B (HepB) vaccine's offered to all babies whose mothers have hepatitis B.

Hepatitis B infection can be passed from an infected mother to her baby. Babies born to mothers with hepatitis B are at high risk of developing hepatitis B themselves. The best way to help protect your baby against hepatitis B is to immunise them from birth.

What's hepatitis B?

Hepatitis B is a virus that infects the liver. Many people with hepatitis B have no symptoms at all and don’t know they're infected. Others have flu-like symptoms and yellowing of the skin (jaundice).

Hepatitis B infection can only be identified by a blood test. Many adults with hepatitis B recover fully but about 1 in 10 adults can remain infectious and spread the infection to others. About 1 in 5 of this group could develop serious liver disease later in life.

More about hepatitis B

How can you become infected with hepatitis B?

The hepatitis B virus is carried in the blood and other body fluids. There are 3 main ways infection is spread:

• By sexual intercourse with an infected person without a condom
• By direct contact with the blood of an infected person, for example by sharing toothbrushes and razors, from equipment used for tattooing and body piercing and between drug users who share needles, syringes and other equipment
• From an infected mother to her baby

Why's hepatitis B infection particularly serious for babies?

Without immunisation, many babies born to mothers who've hepatitis B will become infected.

As many as 9 out of 10 babies who become infected with the hepatitis B virus will develop a long-lasting infection and may develop serious liver disease later in life.

If your baby's fully immunised, they have a 95% chance of being protected from hepatitis B for life.

Are all babies offered protection against hepatitis B?

Yes, from October 2017, the hepatitis B vaccine became part of the routine immunisation programme offered to all babies at 8, 12 and 16 weeks through the 6-in-1 vaccine.

As well as this, extra doses are offered to babies at birth who were born to mothers who have hepatitis b or live in a house where someone is infected with the virus.

Could my partner and other children be at risk of catching hepatitis B?

Yes. It may be necessary for your partner and any other children to have blood tests and/or a course of the vaccine.

It's very important that your baby is given the first dose of the vaccine at birth. Your baby will need further doses of vaccine for full protection against infection.

Some babies may also be given an injection of protective antibodies – you'll be told if this is advised for your baby.

It's important for your baby to receive a full course of hepatitis B vaccine at the right time in order for it to work.

What vaccine's used?

The Infanrix hexa, Powder and suspension for suspension for injection is routinely used in Scotland.

Babies born to mothers with hepatitis B (or who live in a house where someone is infected with the virus) will be offered additional doses of hepatitis B vaccine, either Engerix B or HBVAXPRO.

Both are routinely used in Scotland and will be outside of those usually offered through the 6-in-one vaccine.

Course of immunisation

The full course consists of:

*The doses at 8, 12 and 16 weeks are offered to all babies as part of the 6-in-1 vaccine in the routine immunisation programme.

Your baby will need a blood test at 12 months to check for hepatitis B infection.

How effective is the vaccine?

If your baby is fully immunised, they have a 95% chance of being protected from hepatitis B for life.

Will it be safe to breastfeed?

Yes, but your baby should still receive a full course of the vaccine.

How do we know the vaccine's safe?

All medicines (including vaccines) are tested for safety and effectiveness by the Medicines and Healthcare Products Regulatory Agency (MHRA). The vaccine meets the high safety standards required for it to be used in the UK and other European countries. The vaccine has been given to millions of people worldwide.

Once they're in use, the safety of vaccines continues to be monitored by the MHRA.

All babies are offered the 6-in-1 (DTaP/IPV/Hib/HepB) vaccine when they're 8, 12 and 16 weeks old as part of their routine baby vaccines at a baby clinic or GP practice. This vaccine protects against 6 diseases including hepatitis B (HepB).

Babies born to mothers who've been diagnosed with hepatitis B, need extra doses of the vaccine for full protection. In addition to the doses offered to all babies at 8, 12 and 16 weeks, these babies will also need extra doses at birth, 4 weeks and 12 months. A blood test at 12 months to check for hepatitis B infection will also be offered.

It's very important that your baby is given the first dose of the vaccine in the hospital at birth. You'll be informed by letter where and when you'll get the additional immunisations. If you're unsure please contact your midwife, health visitor or GP.

Improving how vaccines are offered in Scotland

To improve how vaccinations are offered to you or your child, you may notice:

• you're invited to a new location to receive your immunisations instead of your GP practice
• the health professional giving your immunisations changes

You'll still receive clear information about the location, date and time of your appointment.

After the vaccination there may be side effects, but these are usually mild.

Side effects

Your baby may get a little redness, swelling, or tenderness where the injection was given. This will disappear on its own.

Infant paracetamol

Vaccines protect your baby against the risk of very serious infections and should not be delayed.

Fever can be expected after any vaccination.  Fevers are usually mild, so you only need to give a dose of infant paracetamol if your child isn’t comfortable or is unwell.  Read the instructions on the bottle very carefully. 

Fever is more common when the MenB vaccine is given with the other routine vaccines at 8 and 16 weeks.  Infant paracetamol should be given to babies after each of these immunisation appointments.

Public Health Scotland’s booklet What to expect after immunisations: Babies and children up to 5 years has more information.

In infants who do develop a fever after vaccination, the fever tends to peak around 6 hours after vaccination and is nearly always gone completely within 2 days. 

Ibuprofen can be used to treat a fever and other post-vaccination reactions.  Giving ibuprofen at the time of vaccination to prevent a fever is not effective.

Remember, never give medicines that contain aspirin to children under 16.

Information about treating a fever in children.

If an infant still has a fever 48 hours after vaccination or if parents are concerned about their infant’s health at any time, they should seek advice from their GP or NHS 111. 

The diseases vaccines protect against are very serious and therefore vaccination should not be delayed because of concerns about post-vaccination fever.

If you're worried about your child, trust your instincts. Speak to your GP or phone the 111 service.

Read more about the common side effects of immunisations that might occur in babies and young children up to 5 years of age.

Where can I report suspected side effects?

You can report suspected side effects of vaccines and medicines through the Yellow Card Scheme.

This can be done by:

• visiting the Yellow Card Scheme website
• phoning the free Yellow Card hotline on 0808 100 3352 (available Monday to Friday, 10.00am to 2.00pm)

If you’re unsure about anything, or have any questions about the hepatitis B vaccine, phone:

• your GP practice
• the NHS inform helpline

Immunisation leaflet

NHS Health Scotland have produced a leaflet explaining the hepatitis B vaccine in Scotland, why it's offered and when it's given.

This leaflet's also available in Easy Read English and other languages - including Polish, Mandarin (Simplified Chinese) and Arabic.

Protecting your child

Protect your child against serious diseases (Leaflet)

Protect your child against serious diseases (Audio)

Protect your child against serious diseases (BSL)

After immunisation

What to expect after immunisations in babies and young children (Audio)

What to expect after immunisation: Babies and young children (Leaflet)

What to expect after immunisation: Babies and young children (BSL)