Hepatitis B is a viral infection of the liver. It can resolve without treatment, or it may worsen and cause cirrhosis or liver cancer. A vaccine against the virus that causes hepatitis B has been available since the 1980s.

For many people, hepatitis B is a short-term condition and causes no permanent damage. However, according to the Centers for Disease Control and Prevention (CDC), 2–6% of adults with hepatitis B develop a chronic infection. A chronic hepatitis B infection can lead to complications, such as cirrhosis, liver failure, and liver cancer.

The hepatitis B virus (HBV) causes hepatitis B, and there has been a vaccine against HBV available in the United States since the 1980s. The vaccine protects people from infection and stops them from developing hepatitis B.

There are different vaccine series available depending on the age group. For example, infants under 1 year old can receive the vaccine in three or four doses, and those over 1 year can receive a two- or three-dose vaccine series. A person should speak with a doctor to help decide which vaccine series is suitable for them.

This article will discuss the different hepatitis B vaccine schedules. It will also look at who should or should not get the vaccine.

A doctor holding a hepatitis B vaccine.Share on Pinterest
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According to the Hepatitis B Foundation, an infant may receive the vaccine in three or four doses:

  • Three-dose vaccine series: Medical professionals recommend that all medically stable infants in the U.S. who have a birth weight of at least 2,000 grams receive the first dose of their hepatitis B vaccine within 24 hours of birth.
  • Four-dose vaccine series: Combination vaccines, such as the vaccines that feature in this series, protect against various diseases. An infant often receives the first dose of the combination vaccine at 6 weeks of age. This means an infant is not protected against hepatitis B until they are 6 weeks old. Therefore, an infant should receive a dose of the hepatitis B vaccine within 24 hours of birth.

The recommended HBV vaccine schedules for children under 1 year old are outlined in the table below:

Vaccine seriesBrand nameDose 1Dose 2Dose 3Dose 4
3-dose vaccine seriesEngerix-B or Recombivax HBat birth4 weeks after birth6 months after the first dose
4-dose combination vaccine seriesVaxelis or Pediarixat birth

(hepatitis B vaccine)
at 6 weeks old

(combination vaccine)
at 14 weeks old

(combination vaccine)
at 6 months old

(combination vaccine)

The three-dose series is suitable for children and adults. The two-dose series is suitable for adults who are over 18 years old.

The recommended HBV vaccine schedule for people over 1 year old is outlined in the table below:

Vaccine seriesBrand nameDose 1Dose 2Dose 3
3-dose vaccine seriesEngerix-B, Recombivax, or Tinrixday 11 month after the first dose6 months after the first dose
2-dose vaccine seriesHepislav-Bday 11 month after the first dose

In certain circumstances, a person may receive a vaccine series over a shorter period than that of the standard schedule.

A person may have an accelerated vaccine series if they are traveling to an area that puts them at high risk of exposure or are an emergency responder in a disaster area.

For adults and children

This vaccine schedule involves three doses within 2 months, followed by a booster dose at 1 year.

The initial accelerated doses provide immediate protection from HBV, and the booster dose helps provide long-term protection.

Below is the accelerated vaccination schedule approved for both adults and children:

Vaccine seriesBrand nameDose 1Dose 2Dose 3Dose 4
4-dose vaccine seriesEnergix-Bday 11 month later2 months after the first dose1 year after the first dose

For adults only

The four-dose combination vaccine schedule uses a combination vaccine that protects against hepatitis A and B.

This vaccine series includes three doses that a person receives within 1 month. A person then receives a booster dose after 1 year. This schedule is a common choice for people traveling on short notice outside the U.S.

The two-dose vaccine schedule includes two doses that a person receives 1 month apart.

Below are the two accelerated vaccination schedules for adults over the age of 18 years:

Vaccine seriesBrand nameDose 1Dose 2Dose 3Dose 4
4-dose combination seriesTwinrixday 11 week later1 month after the first dose1 year after the first dose
2-dose vaccine seriesHepislav-Bday 11 month later

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

It is important that infants who are born to females with hepatitis B receive accurate doses of the hepatitis B vaccine. They may also be required to receive hepatitis B immunoglobulin (HBIG) if it is available.

The WHO also recommends using antiviral prophylaxis to help prevent hepatitis B transmission.

The table below outlines the two recommended hepatitis B vaccine schedules for infants born to those who have hepatitis B:

Vaccine seriesBrand nameDose 1Dose 2Dose 3Dose 4
3-dose vaccine seriesEngerix-B and Recombivax HBat birth

(hepatitis B vaccine and HBIG)
1 month later6 months after first dose
4-dose combination vaccine seriesVaxelis or Pediarixat birth

(hepatitis B vaccine and HBIG)
at 6 weeks of age

(combination vaccine)
at 14 weeks of age

(combination vaccine)
at 24 weeks of age

(combination vaccine)

Many nations use a combination vaccine that protects against several diseases, including hepatitis B.

The table below outlines the three recommended international hepatitis B vaccine schedules:

Vaccine seriesDose 1Dose 2Dose 3Dose 4
3-dose vaccine series for those under 1 year oldat birth1 month after the first dose6 months after the first dose
3-dose vaccine series for those over 1 year old and adultsday 11 month after the first dose6 months after the first dose
4-dose combination vaccine for those under 1 year oldat birth

(hepatitis B vaccine)
at 6 weeks of age

(combination vaccine)
at 14 weeks of age

(combination vaccine)
at 6 months of age

(combination vaccine)

Medical professionals recommend that all infants receive the hepatitis B vaccine.

According to the CDC, the following people are at a higher risk of contracting hepatitis B than the general population:

  • people with chronic liver disease
  • people with HIV
  • sexually active people who are not in mutually monogamous relationships
  • people in a sexual relationship with someone who has hepatitis B
  • people who inject drugs
  • people who are at an increased risk due to exposure in their job
  • people who travel to countries with high levels of hepatitis B

The hepatitis B vaccine is safe for most people. There are some common minor side effects a person may experience after receiving the vaccine.

These include:

  • soreness or swelling in the arm at the site of injection
  • headache
  • fever

A person should speak to a medical professional before getting the vaccine if they:

  • have had an allergic reaction to a previous dose of the vaccine or any component of a hepatitis B vaccine
  • have had an allergic reaction to yeast
  • have had an allergic reaction to neomycin (Twinrix)

If a person has a minor illness, such as a cold, they can still receive the vaccine. If someone is moderately or severely ill, they should wait until they recover before getting the hepatitis B vaccine.

Hepatitis B is a viral infection of the liver. It spreads via the transfer of bodily fluids from a person with an HBV infection to someone without the infection.

There are a number of vaccines available for hepatitis B. A person receives the hepatitis B vaccine through a series of shots. There are two-, three-, and four-dose vaccine schedules that make use of these vaccines.

A person may also get a combination vaccine that protects against hepatitis B and various other diseases.