Hepatitis B Vaccination for people with Chronic Kidney Disease (CKD)

What is hepatitis B?

Hepatitis B is a serious inflammation of the liver that is caused by a viral infection.

It is spread by contact with blood and body fluids.

If you have long-term hepatitis B infection you can infect other people with the disease, even if you are well.

Around 1 in 5 people living with long-term hepatitis B will develop scarring of the liver. This happens over 10-20 years and is known as cirrhosis.

Why are people with chronic kidney disease at more risk of hepatitis B?

People with CKD are at an increased risk of hepatitis B infection because they are exposed to blood and body fluids during haemodialysis.

Some countries outside the UK have a higher rate of hepatitis B infection, so it is particularly important to be immunised if you plan to have haemodialysis abroad.

Procedures are in place to reduce the risk of hepatitis B infection across all sites supported by the Richard Bright Renal Unit, however the risk cannot be removed completely.

The Department of Health recommend that people with CKD are immunised against the hepatitis B virus. You won't have to pay for the vaccinations.

People who will need dialysis or may have a kidney transplant in the future are all offered immunisation.

People who have had a kidney transplant need to take medicines which dampen their immune system (immunosuppressive drugs). This makes it more difficult for their body to fight infection and can increase the risk of them developing a more severe hepatitis B infection.

The vaccine is safe for people on the kidney transplant waiting list.

Vaccination also prevents the disease spreading and causing harm to other people.

How is the vaccination Given?

The treatment involves a course of injections – which will be given in your upper arm, over a number of months. A nurse at your kidney unit clinic or haemodialysis unit will give you the injections.

The vaccination that will likely be given and the doses are described below, however there are other brands of vaccination available, so this may change. They will be given over a time period of six months.

Vaccination: HB VAX PRO 40®

  • Dose: 40mcg/ml
  • Total number of clinic visits: 3

Vaccination: ENERGIX B®

  • Dose: 40mcg/ml = 2 X 20mcg/ml per dose
  • Total number of clinic visits: 4

The doses of the vaccine used for people with chronic kidney disease are slightly higher than those used for people without kidney disease.

What happens when I have the vaccine?

The vaccination will encourage your body to produce antibodies to fight the hepatitis B virus – in case it  enters your blood stream. 

Your kidney doctor, pre-dialysis or dialysis nurse will arrange for you to have a blood test to measure your antibody level once you have completed the course of injections (2 months after you receive the 3rd dose).

For your protection, it is recommended that your antibody level is greater than 100mlU/ml. 

A level between 10 & 100 mlU/ml – will still give you some protection, but your doctor/nurse may recommend a further injection of the hepatitis B vaccine (a booster).

If you are on haemodialysis your hepatitis B antibody levels will be measured every year. If you level drops below 10mlU/ml you may be advised to have a booster injection.

For the immunisation to be most effective – it is very important that you have the injections at the recommended time and complete the course. Your doctor/nurse will remind you when your injections are due. We can provide you with a hepatitis B vaccination card if you wish.

Does the vaccine have any side-effects?

As with any vaccine, you may have a reaction or experience side-effects. These may include the following:

Common (about 1 in 10 people): 

  • Redness, tenderness, pain, and swelling at the injection site (this usually only lasts a few days).
  • Headache. 

Uncommon (about 1 in 100 people): 

  • Fever or flu-like symptoms.
  • Skin rash.

Very rare (less than 1 in 10,000 people):

  • Severe reaction: swelling of your face with difficulty breathing (anaphylactic reaction). 

Whoever gives you your vaccine will discuss possible side-effects with you. 

Who should not have the vaccine?

Before you have the first dose of the hepatitis B vaccine, please tell your doctor/nurse if you have had a severe reaction to any vaccine in the past.

If you have had a previous severe reaction to the hepatitis B vaccine you should not have another Hepatitis B vaccination.

If you have a high fever or severe infection when your vaccination is due, the vaccine should be given after you have recovered. If you have a minor infection e.g. cold – this should not be a problem with having the vaccination. You can discuss this with the nurse/doctor before you receive the jab.

There is no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.

NHS Website: Hepatitis B - NHS (www.nhs.uk)

Please speak to your kidney doctor or renal nurse if you are unsure of anything or if you have any further questions or website: Renal (Kidney) | North Bristol NHS Trust (nbt.nhs.uk)

© North Bristol NHS Trust. This edition published February 2024. Review due February 2027. NBT002096. 




Hepatitis B Vaccination for people with Chronic Kidney Disease (CKD)