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Hepatitis B

Key facts

  • Hepatitis B is a liver infection.

  • Children usually don’t look or feel sick when they first catch hepatitis B, but it can cause serious liver diseases, including liver cancer, later in life.

  • Vaccines are the best way to protect your child against hepatitis B.

Last updated on 23 April 2023.

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What is hepatitis B?

Hepatitis B is a liver infection. Children usually don’t look or feel sick when they first catch hepatitis B, but it can cause serious liver diseases, including liver cancer, later in life. It spreads from person to person through open wounds or sores. This can happen in households or even childcare settings. People infected with hepatitis B can pass on the disease without even knowing they have it.1

What will happen to my child if they catch hepatitis B?

Usual symptoms

  • Babies or children with hepatitis B infection don’t usually have any symptoms at all.
  • Up to 90 per cent of people who get hepatitis B as babies or children develop a chronic (long-term), hidden hepatitis B infection but don’t know it.
  • Around 30 to 50 per cent of adults who catch hepatitis B experience fever, nausea, vomiting, tummy pain, fatigue (severe tiredness or loss of energy), muscle aches, jaundice (yellow skin and eyes), their urine (wee) gets very dark, and their poo looks very pale. They can also get a rash and sore, swollen joints. The fatigue can last for many weeks. 
  • Around 10 per cent of people who catch hepatitis B as adults develop long-term hepatitis B. 
  • Around 25 per cent of people with long-term hepatitis B infections develop liver cancer or cirrhosis (scarring) on their liver that stops the liver from working properly and can lead to death.  
  • People who have long-term hepatitis B infections usually don’t know until after their liver is scarred or they get liver cancer.

Rare symptoms

  • About 1 per cent of people who catch hepatitis B as adults develop very severe liver disease soon after they catch it.
What vaccine will protect my child against hepatitis B?

In Australia, newborns get a hepatitis B vaccine, usually in the hospital. From two months old, children receive a combined vaccine (also called ‘hexavalent’), which strengthens immunity to hepatitis B, as well as diphtheria, tetanuspertussis, Hib and polio.

When should my child be vaccinated?

It is recommended that children get a vaccine that protects against hepatitis B at birth, two months, four months and six months.

It is important that children get all their vaccinations on time to ensure they have the best possible protection against infectious diseases.

Will my child catch hepatitis B from the vaccine?

No, there is no risk that your child will catch hepatitis B because the vaccine does not contain the live virus that causes the disease. Instead, it contains inactive parts of the hepatitis B virus that train your child’s immune system to recognise and fight the infection.

What are the common reactions to the vaccine?
  • Up to 33 per cent of children who have vaccines that protect against diphtheria, tetanus, pertussis (whooping cough), Hib, or polio experience redness at the injection site that lasts up to a few days.
  • Up to 20 per cent of children who have vaccines that protect against diphtheria, tetanus, pertussis (whooping cough), Hib, or polio develop a mild fever that lasts one or two days. 
  • About 10 to 13 per cent of people who have vaccines that protect against diphtheria, tetanus, pertussis (whooping cough), Hib, polio, or hepatitis B experience mild swelling or pain at the injection site that lasts one or two days. 
  • About 5 to 10 per cent of babies who have vaccines that protect against polio experience decreased appetite.
  • About 2 per cent of people who get booster doses of a vaccine that protects against diphtheria, tetanus and pertussis (whooping cough) get a sore red, swollen arm. The swelling starts in the first two days after vaccination. It lasts for one to seven days and then gets better. 
  • About 1 per cent of children who have a vaccine that protects against polio get a hard lump at the injection site that lasts a few days or weeks. 
Are there any rare/and or serious side effects to the vaccine?
  • Babies who get a fever (for any reason) occasionally experience a fit (febrile convulsion) that lasts from a few seconds to a few minutes. Febrile convulsions don’t have long-term effects on a child’s health and development.
  • Some people who get vaccines that protect against hepatitis B experience nausea or aches in their muscles or joints in the days afterwards.
  • About 0.0032 per cent of children aged 12 months or under who get a vaccine that protects against pertussis (whooping cough) experience hypotonic-hyporesponsive episodes (HHE). These children get very pale, go limp, and don’t respond to their surroundings. Their lips and fingernails can also turn blue. Most reactions last less than 30 minutes and can occur anytime from vaccination up to about 48 hours after vaccination.2 HHEs don’t have any long-term effects on children’s health.
  • About 0.0001 per cent of people have an allergic reaction following vaccination that affects their whole body, called anaphylaxis. This reaction usually happens within 15 minutes of getting the vaccination and can be treated by giving an injection of adrenaline. People who have this reaction usually recover quickly and don’t experience any long-term effects.

If your child doesn’t seem to be getting better, or you are worried about them, you can get help from:

  • your doctor
  • your nearest emergency department
  • or by calling Health Direct on 1800 022 222.

  1. Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health, Canberra, 2018, immunisationhandbook.health.gov.au
  2. Melbourne Vaccine Education Centre. Hypotonic-hyporesponsive episode (HHE). 2022. https://mvec.mcri.edu.au/references/hypotonic-hyporesponsive-episode-hhe/