Hepatitis B and the Hepatitis B Vaccine

About Hepatitis B

Hepatitis B is a serious infection of the liver caused by the hepatitis B virus. In some people the infection will not go away, and may lead to liver disease, liver cancer or even death. Across Canada and the world, chronic hepatitis B infections are the most common cause of liver cancer.  There is no cure for hepatitis B, but there is a vaccine available for free in Canada to protect against it. Vaccination is the best way to protect against hepatitis B.  

Hepatitis B is spread through contact with infected blood or other bodily fluids, including:  

• a pregnant parent to their baby during pregnancy or birth 

• direct contact with infected blood or open sores 

• sharing personal items like toothbrushes, razors, syringes and needles 

• unprotected sexual activity 

• unsterilized equipment for tattooing, acupuncture or body piercings  

Symptoms

Many people infected with hepatitis B do not have any symptoms and do not realize they have it. Even without symptoms, an infected person can still spread the virus to someone else.  

If symptoms do appear, they can take several months to develop and may include:  

• Fatigue 
• Stomach pain or abdominal discomfort 
• Fever 
• Joint pain 
• Loss of appetite 
• Nausea and vomiting 
• Weakness and tiredness 
• Dark urine 
• Jaundice (yellowing of the skin and eyes) 

Risks

Hepatitis B is 50 to 100 times more infectious than HIV. If acquired, some people can get better on their own and develop protection against it. Others may remain infected and have the virus in their body for the rest of their lives, usually not showing symptoms and passing the virus onto others without realizing it. Infants, children and people with weak immune symptoms are groups more likely to have trouble clearing the virus from their body on their own and can carry it for life. For example, about 90 percent of infants infected with the hepatitis B virus will be infected for life. 

Lifelong carriers are at high risk of liver failure, cirrhosis (permanent damage and scarring of the liver) and liver cancer.  

Who should get the vaccine? 

The hepatitis B vaccine is recommended for everyone. It is much safer to get the hepatitis B vaccine than to get hepatitis B.  

Speak with your healthcare provider to confirm whether you or your child(ren) should not get the hepatitis B vaccine. 

The vaccine is not recommended for people with:

• A severe allergic reaction to the vaccine or it’s container/ingredients 
• A history of serious allergic reactions to this vaccine in the past 
• High fever or serious infection worse than a common cold at the time of vaccination 

Why is the hepatitis B vaccine given in Grade 7? 

The hepatitis B vaccine is offered as early as Grade 7 in Ontario because: 

• Youth can be protected before they ever have contact with the virus – the vaccine does not protect people who are already infected with hepatitis B. 
• At this age, youth produce a stronger immune response compared to adults. Preteens make more antibodies after getting the vaccine than older teenagers or adults, which provides long-lasting protected against hepatitis B.  
• Grade 7 students only require 2 doses of the vaccine, while youth 15 years or older require 3 doses.    

Is the hepatitis B vaccine free? 

Some groups are eligible for the publicly funded (free) hepatitis B vaccine in Ontario: 

• Youth in Grades 7-12 
• Individuals who meet certain high-risk criteria (e.g., persons who use intravenous drugs, men who have sex with men) 
• Infants born to hepatitis B infected mothers  

Outside of the publicly funded program, the cost of the hepatitis B vaccine is approximately $67 to $90 per dose, depending on if an adult or pediatric dose is needed. Some individuals may have the vaccine covered with private health insurance. 

Does the hepatitis B vaccine work? 

When you receive the complete series (two or three doses, depending on your age), the hepatitis B vaccine is between 95 to 100 percent effective at preventing hepatitis B infection.  

Is the hepatitis B vaccine safe? 

Yes, the hepatitis B vaccine is safe. The hepatitis B vaccine is approved and recommended by Health Canada and the National Advisory Committee on Immunization (NACI) based on decades of effectiveness and safety research. The vaccine is also generally well-tolerated.  

Learn more about the safety of the hepatitis B vaccine from Health Canada.  

Potential side effects

Like any medicine or medical treatment, vaccines can have side effects. However, the hepatitis B vaccine is one of the most well-tolerated vaccines, and the side effects that may occur are usually mild and go away within a few days.   

Common side effects or reactions include: 

• Soreness, redness and/or swelling at the injection site 
• Fever 
• Headache 
• Nausea 
• Diarrhea 

Severe allergic reactions (i.e. anaphylaxis) are very rare. It is recommended that you stay at the clinic for 15 minutes after getting the vaccine as this is the most common timeframe when anaphylaxis occurs.  

How can I manage the side effects of the vaccine? 

If pain or swelling at the injection site occurs, consider applying a cool, wet cloth or wrapped ice pack over the area. Tylenol ® or Advil ® can also be taken for fever or soreness.  

Seek medical attention right away if you notice: 

• Hives 
• Difficulty breathing or swelling of the throat, tongue or lips 
• A seizure 
• A fever lasting more than 3 days 
• Severe vomiting or diarrhea   

How can I get the hepatitis B vaccine? 

• Students in Grades 7-8 can receive the hepatitis B vaccine at their school for free as part of the Grade 7 school immunization clinics offered by WDG Public Health. 
• Students in Grades 9-12 can receive the hepatitis B vaccine at their school for free as part of high school immunization clinics offered by WDG Public Health. 
• Anyone may also get the hepatitis B vaccine at their local public health unit. Call 1-800-265-7293 ext. 7006 to book an appointment with WDG Public Health. 
• Anyone may also get the hepatitis B vaccine from their primary care provider (i.e., family doctor, nurse practitioner). 

• Hepatitis B | The Immunization Well-Child Toolkit | ontario.ca
• Hepatitis B | immunizecanada.ca