Immunization Articles

Hepatitis B Vaccine: What Parents Need to Know

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Hepatitis B is a viral infection of the liver. It is caused by the hepatitis B virus (HBV). Lifelong HBV infection can lead to liver cancer or scarring of the liver (cirrhosis). More than 1 million people in the United States are living with lifelong HBV infection. Anyone can get infected with HBV, including your child.

The hepatitis B vaccine is the best way to ­protect your child from becoming infected. Read on for more information from the ­American Academy of Pediatrics about how HBV is spread and why the hepatitis B vaccine is so important.

How is hepatitis B virus spread?

Hepatitis B virus is spread by blood or body fluids. Here are ways exposure to these fluids can happen.

  • During birth (if the mother has HBV)

  • Sharing personal items, such as razors or toothbrushes, with a person who is infected

  • Having unprotected sex with a ­person who is infected

  • Injecting or shooting drugs using a needle with infected blood

Some children may also become infected with HBV while living in the same household as a person with a lifelong form of the infection. It is unknown how this happens.

Why is my child at risk?

You may feel your child will never be exposed to HBV in any of these ways. Here are some facts about HBV to think about.

  • One-third of people who are infected with HBV in the United States don’t know how they got it.

  • Some people with HBV do not even know they are infected.

  • A person, especially a child, with HBV may not feel or look sick.

  • Nearly half of the more than 5,000 adult Americans who die from hepatitis B each year caught their infection during childhood.

People with HBV can pass it to others who aren’t protected. Immunizing your child against this virus will protect her now and when she is older and exposed to more people.

Is the hepatitis B vaccine safe?

The vaccine is very safe. No serious reactions have been linked to this vaccine. Side effects are usually mild and include fussiness or soreness where the shot was given. Symptoms usually go away within 48 to 72 hours. Keep in mind that getting the vaccine is much safer than getting the disease.

When should my child get the hepatitis B vaccine?

Your child needs at least 3 doses of hepatitis B vaccine to be fully protected. The recommended times to receive hepatitis B vaccine are

  • At birth

  • At 1 to 2 months of age

  • At 6 to 18 months of age

Newborns who don’t get the vaccine at birth should get all 3 doses as soon as possible at the recommended intervals.

If a pregnant woman tests positive for HBV, her child must be vaccinated as soon as possible (preferably within 12 hours of birth). The second dose should be given at 1 to 2 months of age, and the final dose by 6 months of age.

Older children or teens who have not been ­immunized and any unvaccinated person living with a person who is known to be infected by HBV should receive 3 doses of the vaccine to protect against infection.

It’s important that your child gets all 3 doses. More than 95% of children who receive all the recommended doses of the vaccine are fully protected against the illnesses caused by HBV.

Who should not get the vaccine?

In rare cases, there are children who should not get the vaccine, including

  • Children who had a severe allergic reaction to a previous dose of the vaccine. Such reactions are rare.

  • Children who are more than mildly sick on the day the vaccination is scheduled. These children may need to wait until they are feeling better. Children with minor colds, an upset stomach, or an ear infection can receive the hepatitis B vaccine safely.


Immunizations have protected children for years, but vaccines only work if your child is immunized. It only takes 3 doses of the hepatitis B vaccine to protect your child for a lifetime.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2005 American Academy of Pediatrics, Updated 10/2016. All rights reserved.

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