Hepatitis B Vaccine Across The UK

Hepatitis A, B and C are separate viral infections that all affect the liver, but they are caused by different viruses and spread through different routes.

• Hepatitis A spreads through contaminated food and water and causes an acute illness that clears without treatment, with no chronic phase.
• Hepatitis B spreads through blood and body fluids, including through unprotected sex and shared needles, and can become a chronic infection with serious long-term consequences. Vaccines exist for both hepatitis A and B.
• Hepatitis C also spreads through blood and has no licensed vaccine, but it is now curable with antiviral medication.

Prevalence is highest in sub-Saharan Africa and East Asia, where five to ten per cent or more of the adult population may be chronically infected. High rates are also found in Southeast Asia, South Asia, Central Asia, Eastern Europe, parts of the Pacific Islands and parts of South America. The UK, Western Europe, North America and Australia have low prevalence. Travellers to high-prevalence regions, particularly those who may require local medical or dental care, face a real exposure risk without vaccination.

After completing a full hepatitis B course, most healthy adults have long-lasting and likely lifelong protection. Routine boosters are not currently recommended for immunocompetent adults who have completed the primary series. Healthcare workers and immunocompromised individuals may be tested to check their antibody levels and advised on whether additional doses are needed.

Adults born from August 2017 onwards may have received hepatitis B as part of the NHS six-in-one childhood vaccine. If you completed the full three-dose course in infancy, you are likely to have long-lasting protection and re-vaccination is not usually needed. If you were born before 2017, you were not included in the childhood hepatitis B schedule and may have no protection unless you were vaccinated for another reason. If you are uncertain, a blood test to check your antibody levels can confirm your status.

Side effects are usually mild. Soreness, redness or mild swelling at the injection site is the most commonly reported reaction. A low-grade fever, mild headache or brief fatigue in the one to two days following vaccination is reported by some patients. Serious reactions are uncommon. Your clinician will go through what to expect before the first injection.

For most travellers, a post-vaccination blood test is not routinely needed. Healthcare workers, immunocompromised individuals and those who have previously had hepatitis B infection may be advised to have an anti-HBs titre measured to confirm their immune response. Your clinician will advise whether this applies to you at your pre-vaccination consultation.

The hepatitis B virus spreads through direct contact with infected blood or body fluids. Routes of transmission include unprotected sexual contact; sharing needles, syringes or other injecting equipment; needlestick injuries; transmission from a hepatitis B-positive mother to her baby during or shortly after birth; and use of unsterilised medical, dental or tattooing instruments. Sharing personal items that may carry traces of blood, such as razors or toothbrushes, is also a route. Hepatitis B is not spread through casual contact, coughing, sneezing or sharing food and drink.

The right schedule depends on your departure date and how urgently you need protection.

If you are travelling in the next three weeks, the rapid schedule (three doses over 21 days) gives meaningful protection before departure, with a booster at twelve months. If you are departing in the next two to three months, the accelerated schedule (doses at months 0, 1 and 2, with a booster at month 12) suits most planned trips. If your travel is six months or more away, the standard schedule (doses at months 0, 1 and 6) provides the highest immune response without a separate booster. Your clinician will confirm the best option at your pre-vaccination appointment.

The NHS provides hepatitis B vaccination to specific groups: babies born to hepatitis B-positive mothers, sexual and household contacts of confirmed carriers, people who inject drugs, sex workers, prisoners and certain healthcare workers. For adult travellers who do not fall into these categories, NHS hepatitis B vaccination is not routinely offered. Private vaccination is the standard route for most adults seeking protection before travel.

Yes. The rapid schedule consists of three doses given at day 0, day 7 and day 21, making it possible to complete the course within three weeks of your first appointment. The first dose can be given at your initial consultation. A booster dose at twelve months is required to establish long-term protection. Same-day first appointments are often available at our clinics.

Yes. Twinrix is a licensed combined hepatitis A and B vaccine available at our clinics, given as three doses at months 0, 1 and 6. An accelerated Twinrix schedule is also available for those with less lead time. It is a convenient option for those needing protection against both viruses. Your clinician will confirm whether Twinrix or separate vaccines are more appropriate based on your travel dates and previous vaccination history.

Yes. A paediatric formulation of Engerix-B is available for children under sixteen. We vaccinate children at all our clinics. Please let us know when booking that you are bringing a child so we can confirm the correct formulation and dose.