How to vaccinate and protect against Hepatitis B and C

Overview

Hepatitis C is a viral infection that attacks the liver. It can cause both acute (short-term) and chronic (long-term) illness, and in severe cases it can be life-threatening. Because the liver plays such an important role in keeping our body healthy, untreated infection can gradually lead to serious health problems.

The virus spreads mainly through contact with infected blood. This can happen in several ways. For example, unsafe injections or medical procedures may expose patients to contaminated equipment. Blood transfusions that are not carefully screened also pose a risk. Sharing needles or syringes among people who inject drugs is another common way the virus spreads. Certain sexual practices that involve blood exposure can also transmit hepatitis C.

Common Symptoms

Many people with hepatitis C do not notice symptoms at first, especially in the early stage of infection. When symptoms do appear, they can include fever, tiredness, loss of appetite, nausea, vomiting, abdominal pain, or dark urine. Some people also develop jaundice, which causes the skin and eyes to turn yellow. Because symptoms are often mild or absent, many people live with hepatitis C without realizing it.

Key Facts

There is currently no vaccine for hepatitis C. However, the good news is that it can be treated and cured with antiviral medicines. Getting tested and treated early can prevent long-term liver damage. About 30% of people infected with hepatitis C naturally clear the virus within six months, without treatment. But for the other 70%, the infection becomes chronic. Among those with chronic infection, 15–30% develop cirrhosis, or scarring of the liver, within 20 years.

A Research Assistant with the C-Free programme conducts a blood test with a participant to check if treatment for hepatitis C was successful (22 March 2024, Thailand). C-Free is the first community-based study in Thailand offering hepatitis and HIV testing and treatment for people who use drugs and their partners. (Photo credit: © WHO / Laureen DeCicca)

Because there is no vaccine, the best protection against hepatitis C is prevention. That means avoiding contact with infected blood and reducing risk wherever possible.

Some groups of people are more likely to be exposed to hepatitis C. These include people who inject drugs and may share needles or syringes, men who have sex with men, and people living with HIV. Individuals who need repeated medical procedures or blood transfusions also face a higher risk, especially where health systems do not have strong infection-control measures.

How to Stay Protected

There are several ways to prevent hepatitis C. The first is to ensure all medical procedures and injections are carried out safely, with sterile equipment. Proper handling and disposal of needles and other medical waste also reduce the chance of infection spreading. For people who inject drugs, harm-reduction services such as needle exchange programmes, counselling, and opiate agonist therapy provide safer alternatives. Testing all donated blood before transfusion is another critical step. Finally, practicing safe sex by using condoms or other barrier methods can lower the risk of transmission through sexual contact.

Learn more from the WHO Hepatitis C Fact Sheet

Hepatitis B and C: The Link

Hepatitis B (HBV) and Hepatitis C (HCV) are caused by different viruses, but they share the same ways of spreading. Because of this,some people may be infected with both at the same time — this is called coinfection.

Having both viruses together can make liver disease progress more quickly and cause more severe health problems. In some cases, the hepatitis C virus can suppress hepatitis B to undetectable levels, which makes testing and treatment more complicated. Managing coinfection requires careful medical attention, as medicines for one virus may affect the other.

Although both viruses cause liver inflammation, there is an important difference. Hepatitis B can be prevented with a safe and effective vaccine. By contrast, hepatitis C cannot be prevented with a vaccine, but it can be treated and cured with direct-acting antiviral medicines. Only HBV can infect the placenta and cause an intrauterine infection, leading to maternal-to-child transmission. This makes testing and prevention even more critical.

Hepatitis B Prevention and Vaccination

The World Health Organization has long recognized the serious health problems caused by hepatitis B, including liver cancer and cirrhosis. To protect communities, WHO recommends that every country include the hepatitis B vaccine in its national immunization programme.

Global Recommendations

Vaccination is the most effective way to prevent hepatitis B infection. All children should receive at least three doses of the hepatitis B vaccine, starting with a birth dose within 24 hours after birth. This first dose is essential to protect newborns from infection passed from mother to child. Follow-up doses ensure lasting immunity. Widespread vaccination is the best defense against the disease.

Thailand’s Progress

Thailand has made remarkable progress in protecting its population from hepatitis B. The vaccine was first introduced in 1988 as a pilot project in Chonburi and Chiang Mai as part of the National Immunization Program. By 1990, it expanded to 12 provinces, and in 1992, it became available nationwide. The standard schedule includes doses at birth, 2 months, and 6 months of age. In 2019, Thailand introduced the combined DTP-Hib-HepB vaccine, which has further reduced hepatitis B cases. 

To prevent mother-to-child transmission of Hepatitis B, Thailand’s antenatal care programmme screens all pregnant women for Hepatitis B.  High-risk mothers are provided with antiviral prophylaxis during pregnancy.  For newborns of HBsAg-positive mothers, the strategy combines an immediate dose of Hepatitis B Immune Globulin (HBIG) with the first hepatitis B vaccine at birth, followed by additional doses at 1, 2, 4 and 6 months to ensure long-term immunity.  Today, the country continues to strengthen its vaccination and screening programmes, particularly for pregnant women, to protect the next generation.

A nurse at Siriraj Hospital, Bangkok, collects a blood sample from a pregnant woman. Thailand has a strong screening programme to protect mothers and newborns from hepatitis B. (Photo credit: WHO SEARO / C. McNab)

Hepatitis C has no vaccine, but with the right medicines it can be cured. Hepatitis B, on the other hand, can be prevented with a safe and effective vaccine. By practicing safe behaviours, getting tested, and ensuring vaccination, we can protect ourselves, our families, and our communities from serious liver disease.