Ask the Experts: Hepatitis B: Contraindications & Precautions

Results (2)

Yes. Many years of experience with Engerix-B and Recombivax HB brands of HepB vaccines indicate no apparent risk for adverse events to a developing fetus. Current HepB products contain noninfectious hepatitis B surface antigen (HBsAg) and should pose no risk to the fetus. If not vaccinated, a pregnant person may contract an HBV infection during pregnancy, which might result in severe disease for the newborn.

Available human data on Heplisav-B and PreHevbrio administered during pregnancy are insufficient to assess vaccine-associated risks in pregnancy. For this reason, until safety data are available for Heplisav-B or PreHevbrio, providers should continue to vaccinate people needing HepB during pregnancy with either Engerix-B or Recombivax HB. Pregnancy testing prior to vaccination is not recommended.

Mothers who breastfeed their babies and need HepB can be vaccinated. Although data are not available to assess the effects of Heplisav-B and PreHevbrio on breastfed infants or on maternal milk production and excretion, there is no theoretical risk to the infant and vaccination with any HepB product is acceptable.

Last reviewed: July 21, 2023

A serious allergic reaction to a prior dose of HepB or a vaccine component is a contraindication to further doses of HepB. Engerix-B, Recombivax HB, Twinrix, and Heplisav-B are synthesized in yeast cells into which a plasmid containing the gene for HBsAg has been inserted. People with a severe allergic reaction to yeast should not be vaccinated with vaccines produced in yeast cells. PreHevbrio is produced in mammalian cells and may be used (in the absence of other contraindications) in an adult with a severe allergic reaction to yeast.

As with other vaccines, vaccination of people with moderate or severe acute illness, with or without fever, should be deferred until the illness improves. Vaccination is not contraindicated in people with a history of multiple sclerosis, Guillain-Barré syndrome, or autoimmune diseases such as systemic lupus erythematosus or rheumatoid arthritis.

Last reviewed: July 21, 2023

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