Hepatitis B Vaccine in Singapore

Should I Get the Hepatitis B Vaccine?

Under Singapore's National Childhood Immunisation Schedule (NCIS), all babies born in Singapore receive the Hepatitis B vaccine: the first dose at birth, with the course completed by 6 months as part of the routine 6-in-1 (hexavalent) vaccine. For adults, vaccination is recommended if any of the following apply:

• You were not vaccinated as a child, or have no record and are unsure of your immunity status
• You work in healthcare, laboratory or emergency services, or other roles with potential exposure to blood and body fluids
• You live with or are sexually active with someone who has Hepatitis B
• You have multiple sexual partners, men who have sex with men, or others at higher behavioural risk
• You inject drugs or share injection equipment
• You are on dialysis or are a recipient of regular blood products
• You have diabetes mellitus — international guidance recommends Hepatitis B vaccination for adults with diabetes, who have a modestly higher risk of acute and chronic Hepatitis B
• You have chronic liver disease, including chronic Hepatitis C, fatty liver disease, or unexplained persistently elevated liver enzymes (ALT / AST)
• You were born in a country with high Hepatitis B prevalence (typically ≥2 per cent population prevalence — much of Sub-Saharan Africa, parts of Southeast Asia, the Pacific Islands, and parts of South America)
• You are travelling to a country with high Hepatitis B prevalence, particularly for extended stays or if you may need medical or dental care during the trip

Internationally, the US ACIP has moved to a universal recommendation for Hepatitis B vaccination of all adults aged 19 to 59 (and adults 60+ at risk). Singapore's NAIS has not yet adopted universal adult vaccination, but the broad risk-based approach above captures most adults who would benefit.

If you are unsure whether you are already immune, a simple blood test can check your Hepatitis B surface antibody (anti-HBs), surface antigen (HBsAg) and core antibody (anti-HBc) status — this distinguishes prior vaccination, past infection, or chronic carrier status. Many adult Singaporeans completed the childhood vaccine series and are already immune.

Post-exposure prophylaxis (PEP)

If you have had a high-risk exposure to Hepatitis B — for example, a needlestick injury, sexual contact with a Hepatitis B carrier, or perinatal exposure — vaccination as part of post-exposure prophylaxis is recommended, ideally starting within 24 hours. Your doctor may also recommend a dose of Hepatitis B immunoglobulin (HBIG) alongside the vaccine in higher-risk scenarios (e.g., known infectious source, unvaccinated or known non-responder, newborns of HBsAg-positive mothers).

What to Expect at Your Visit

1. Short consultation — your doctor reviews your medical history, allergies, any current illness, prior Hepatitis B vaccinations, and risk factors. Pre-vaccination antibody testing may be offered. Takes around 10–15 minutes.
2. Vaccine administered — a single injection into the upper arm. Takes seconds.
3. Brief observation — a short wait (typically 15 minutes) to check for any immediate reactions.
4. Follow-up scheduled — our team will book your subsequent doses (1 month and 6 months after the first, for the standard schedule).

Common side effects

• Soreness, redness or swelling at the injection site for 1–2 days
• Mild fever, headache or tiredness
• Occasional dizziness or feeling briefly faint
• Mild muscle aches

Serious reactions are rare. Seek urgent medical help for signs of a severe allergic reaction (difficulty breathing, facial swelling) or a widespread itchy rash.

Precautions and contraindications

Let your doctor know if any of the following apply to you:

• Severe allergic reaction to a previous Hepatitis B vaccine or any of its components
• Severe yeast allergy — this is a contraindication to Engerix-B and Twinrix, as the Hepatitis B surface antigen is produced in yeast cells and trace yeast residuals may remain
• Severe latex allergy — the tip cap of some prefilled syringe presentations may contain natural rubber latex; flag this so your doctor can confirm the presentation used
• Active fever or moderate-to-severe illness on the day of the appointment — vaccination is usually deferred until you have recovered

Pregnancy and breastfeeding

Engerix-B and Twinrix are non-live recombinant vaccines and are considered safe during pregnancy and breastfeeding. Engerix-B is recommended for pregnant women who are at risk of Hepatitis B infection (for example, healthcare workers, partners of Hepatitis B carriers, or those with multiple sexual partners). Newer alternatives such as Heplisav-B and PreHevbrio are not currently recommended in pregnancy due to insufficient safety data.