VACCINE RESOURCE COMMITTEE

of the Edmonton Zone Medical Staff Association

View Full List of Vaccine Questions Here

Hepatitus b Vaccine Question #2:

Who should receive the vaccine?

Routine HB immunization is recommended for all children.

Routine HB immunization is recommended for all children. Pre-exposure HB immunization is recommended for high-risk groups. Post-exposure prophylaxis (PEP) should be offered to:

  • infants born to HB-infected mothers;

  • susceptible persons potentially exposed to blood or bodily fluids containing HB virus or from an unknown source; and

  • susceptible household and sexual contacts of an acute case or chronic carrier of HB.

In Canada, the highest risk of transmission and of subsequent chronic HB carriage is in infants exposed during childbirth to their mothers who are carriers of HB. Other groups at higher risk of HB infection include injection drug users, household contacts of HB carriers, and people at risk of sexually transmitted diseases. Most cases of acute HB occur in unimmunized, household contacts of a HB carrier and people 25 years of age and older who acquire infection through unprotected sexual activity, sharing injection drug equipment, or procedures with percutaneous exposure. People on dialysis are considered at high risk. A high proportion of HB carriers in Canada are immigrants from HB-endemic areas. Also medical tourism is a risk factor to become a hepatitis B carrier. Almost one-third of people with HB infection have no identified risk factors. It should be noted that in Canada blood products have been tested for hepatitis B since the 1970s; therefore, the risk of contracting hepatitis B through blood transfusion is extremely low.

Initial infection with HB may be asymptomatic in up to 50% of adults and 90% of children. Acute illness may last up to 3 months and has a case fatality rate of 1% to 2%, which increases with age. Infants, young children and immunocompromised persons are at highest risk of becoming chronic HB carriers.

Sources:

Government of Canada: Hepatitis B vaccines: Canadian Immunization Guide