What are the possible effects of a hepatitis B infection?

In more than 90 out of 100 adults who are infected with hepatitis B, the immune system can effectively fight the virus. If the infection clears up on its own, the virus can no longer be detected in the blood after six months. Sometimes small amounts of the virus remain in liver cells but they don’t cause any problems.

Acute hepatitis B infections only very rarely lead to long-term health issues. If someone has had hepatitis B in the past and recovered from it, it means that their immune system has made antibodies that will most likely keep the virus under control. A hepatitis B infection that lasts longer than six months is considered to be chronic. Over time, chronic hepatitis B can lead to liver damage (liver cirrhosis) and liver cancer. These serious liver diseases don’t necessarily cause noticeable symptoms, or the symptoms may be non-specific.

Babies and children have a lower risk of infection. But if they’re infected, they react more sensitively to the hepatitis B virus and the infection is more likely to become chronic: Only about 10 out of 100 babies and children who are infected with hepatitis B are able to successfully fight the virus. In other words, the infection becomes chronic in about 90 out of 100 babies and children who have it.

Who is the vaccine recommended for?

In Germany, the Standing Committee on Vaccination (Ständige Impfkommission, STIKO) at the Robert Koch Institute is responsible for issuing recommendations about vaccines. They recommend that adults have the hepatitis B vaccine if they have certain risk factors – for instance, if they

• are more likely to come into contact with the hepatitis B virus due to their job or voluntary work (for instance, medical staff, police or first aiders),
• are in close contact with someone who has a chronic hepatitis B infection (such as a relative),
• have an illness that means that a hepatitis B infection could have more serious consequences (for instance, people who have HIV or a chronic liver disease, or people who need dialysis or regular blood transfusions),
• use syringes to inject drugs,
• have many different sexual partners and are a man who has sex with other men,
• travel to a country where hepatitis B is very common.

STIKO also recommends that all babies and toddlers be vaccinated against hepatitis B. For this purpose, there is a combination vaccine that also offers protection against other diseases such as diphtheria, tetanus, polio, whooping cough and haemophilus influenzae type b. Three injections are typically needed to achieve enough protection. Teenagers who haven’t yet been vaccinated are advised to have the vaccine.

In Germany, statutory health insurers pay for all people under the age of 18 to have the vaccines recommended by STIKO. Coverage of high-risk groups or travel vaccinations varies from insurer to insurer, but most statutory health insurers pay for them. If someone would like to be vaccinated against hepatitis because they are traveling to a high-risk area, they are usually given a combination vaccine against both hepatitis A and hepatitis B. You will find more information about travel vaccinations on the website of the World Health Organization.

How well is the hepatitis B vaccine tolerated?

The hepatitis B vaccine is well tolerated. There are no known severe side effects in healthy people.

But the vaccine isn’t suitable for people

• who have an acute illness like the flu that is associated with a high fever or needs to be treated. You can get the vaccine later when you are healthy again.
• who had an overly sensitive reaction to a previous hepatitis B vaccination.

Sources

• Cornberg M, Protzer U, Petersen J et al. Aktualisierung der S3-Leitlinie zur Prophylaxe, Diagnostik und Therapie der Hepatitis-B-Virusinfektion. AWMF-Register-Nr.: 021-011. 2021.
• Gemeinsamer Bundesausschuss (G-BA). Richtlinien über die ärztliche Betreuung während der Schwangerschaft und nach der Entbindung („Mutterschafts-Richtlinien“). 2022.
• McDonald JW, Burroughs AK, Feagan BG et al. Evidence-Based Gastroenterology and Hepatology. Hoboken: Wiley-Blackwell; 2010.
• Poethko-Müller C, Schmitz R. Impfstatus von Erwachsenen in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsbl 2013; 56: 845–857. [PubMed: 23703506]
• Robert Koch-Institut (RKI). Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut 2022 (Epidemiologisches Bulletin 4/2022). 2022.
• Robert Koch-Institut (RKI). RKI-Ratgeber: Hepatitis B und D. 2016.
• Robert Koch-Institut (RKI). Virushepatitis B und D im Jahr 2020 (Epidemiologisches Bulletin 29/2021 ). 2021.
• Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet 2014; 384(9959): 2053-2063. [PubMed: 24954675]

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

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