Hepatitis B vaccination

Safe, highly effective vaccines to prevent hepatitis B virus (HBV) infection have been available since the 1980s. In previously endemic populations, high infant vaccination rates have resulted in a profound reduction in hepatitis B prevalence.

In Australia, universal infant vaccination (a 4-dose schedule given at birth and age 2, 4 and 6 months) was introduced in May 2000. A school-based ‘catch-up’ program for children aged 11 to 15 years took place from around 1998 until 2013. While statistics on birth dose vaccination are not reported at a national level in Australia, high coverage of infant vaccination at age 2, 4 and 6 months has been achieved (around 95%). The birth dose is important to reduce the risk of mother-to-child transmission of hepatitis B.

Hepatitis B vaccination is also recommended for other groups in Australia, including adolescents and adults at greater risk of infection (eg people who inject drugs, men who have sex with men, healthcare workers, susceptible household and sexual contacts of a person with hepatitis B, postexposure prophylaxis), and those at greater risk of adverse outcomes (eg people with chronic liver disease or who are immunocompromised).

All Australian jurisdictions provide funded hepatitis B vaccine for some indications, but these vary. The vaccine is funded for susceptible sexual and household contacts of a person with hepatitis B in all jurisdictions. Information on eligibility and how to obtain funded vaccine is available on the Hep B Help website.

Serological testing before vaccination is recommended in those who are increased risk of hepatitis B infection, to establish their status and exclude existing infection.

Post-vaccination testing to confirm immunity is only required for individuals at greatest risk of exposure to hepatitis B virus, or at greatest risk of adverse outcomes if infection occurs. These include infants born to females with hepatitis B, household and sexual contacts of people with hepatitis B, healthcare workers, people who are immunocompromised, and people with chronic liver disease not related to hepatitis B.

An effective response to hepatitis B vaccination is indicated by a hepatitis B surface antibody (anti-HBs) titre of 10 mIU/mL or more. A person with normal immune function who has ever had a documented anti-HBs titre of 10 mIU/mL or more after completing vaccination is considered to have memory immunity, even if the anti-HBs titre later falls below 10 mIU/mL (titres usually wane over time). Booster vaccination is not required in those with memory immunity.

For information about postexposure prophylaxis for hepatitis B, see Postexposure prophylaxis against bloodborne viruses.

For details about indications for vaccination, available vaccines, schedules, serological testing before and after vaccination, and management of vaccine nonresponse, see the Australian Immunisation Handbook.