Travel Medicine

Vaccination

Hepatitis B

Everyone should be vaccinated against hepatitis B. Neither pregnancy nor lactation are contraindications for hepatitis B vaccination.

Except for certain travelers to highly endemic countries (e.g. risk behavior traveler), the risk of hepatitis B virus (HBV) infection is generally low. When assessing the risk, doctors should consider the duration of travel, the prevalence of HBV carriers in the local population (destination country) and possible intimate sexual contacts, as well as possible contacts with blood and secretions.

Available plasmatic and recombinant vaccines contain particles of non-infectious hepatitis B surface antigen and both are equally safe and immunogenic. Immunization provides protection for at least 15 years, probabily for life, according to actual scientific evidence. Because of the prolonged incubation period of hepatitis B, some protection will be aforded to most travelers following the second dose given before travel, provided that the final dose is given upon return.

Standard primary vaccination series consists usually of three intramuscular doses, both for children and adults, the second dose given 1-2 months after the first, and the third 4-12 months after the second dose. Two other vaccination schedules may be considered for the administration of monovalent hepatitis B vaccine:

- Rapid schedule: three doses given at days 0-30-60, followed by another dose given 6-12 months after the first dose;  and

- Extra-rapid schedule: three doses given at days 0-7-21, followed by a booster given 12 months later.

A combined vaccine against hepatitis B and A may be considered for travellers potentially exposed to both virus. For this combined inactivated vaccine there are three possible schedules:

- Regular: three doses given at days 0-30-180;

- Rapid: three doses given at days 0-30-60, with an aditional dose at 12 months;  and

- Extra-rapid: three doses given at days 0-7-21, with a booster dose at 12 months.

Fernando Costa Silva, 1999 (last update: 2009)