What is the cause of a rash after receiving the Hepatitis B (Hep B) vaccine?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 10, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

A rash after a hepatitis B vaccine is generally a mild and self-limiting side effect that does not require specific treatment, but if severe, it may indicate a rare allergic reaction that necessitates immediate medical attention. The hepatitis B vaccine is known to cause side effects such as pain at the injection site and fever, but these are typically mild and transient 1. The occurrence of a rash can be attributed to the immune system's response to the vaccine, which contains components of the hepatitis B virus designed to stimulate the production of protective antibodies. This immune response can sometimes lead to localized inflammation or a more widespread rash. For mild rashes, over-the-counter antihistamines like diphenhydramine (Benadryl) 25-50mg every 6 hours or cetirizine (Zyrtec) 10mg daily can be used to reduce itching, and applying a cool compress or calamine lotion may also provide relief. However, if the rash is severe, spreads quickly, or is accompanied by difficulty breathing, facial swelling, or other concerning symptoms, it is crucial to seek immediate medical attention as this could indicate a rare but serious allergic reaction 1. It's also important to note that hepatitis B vaccination is contraindicated for persons with a history of hypersensitivity to yeast or to any vaccine component, but there is no evidence to suggest adverse reactions in individuals with a history of yeast allergy 1. The benefits of completing the full hepatitis B vaccination series in preventing serious liver infection outweigh the risks associated with mild side effects like rashes.

Some key points to consider include:

  • The rash is usually self-limiting and resolves on its own within a few days.
  • Mild rashes can be managed with over-the-counter medications and home remedies.
  • Severe rashes or those accompanied by other concerning symptoms require immediate medical attention.
  • The hepatitis B vaccine is safe for individuals without a history of hypersensitivity to its components.
  • Completing the vaccination series is crucial for protection against hepatitis B virus infection.

From the Research

Rash after Hep B Vaccine

  • A study published in 2008 2 investigated the potential association between the HBV vaccine and dermatomyositis, an autoimmune disease characterized by skin rash and muscle weakness.
  • The study reported a case of a 6-year-old child who developed a flu-like disease accompanied by a skin rash with features of dermatomyositis after receiving the hepatitis B vaccine.
  • The skin reactions described in the study were suggestive of an immune complex reaction, which may be triggered by the vaccine.
  • The study also mentioned that similar skin reactions have been reported in carriers of hepatitis B surface antigen and after vaccination with the HBV vaccine, as well as after other vaccinations such as BCG and influenza.
  • The association between vaccination and autoimmunity, including the development of skin rashes, is discussed in the study 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

HBV vaccine and dermatomyositis: is there an association?

Rheumatology international, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.