What Hepatitis B Immunisation Involves
Full protection involves having 3 injections of the hepatitis B vaccine at the recommended intervals.
Babies born to mothers with hepatitis B infection will be given 6 doses of hepatitis B-containing vaccine to ensure long-lasting protection.
If youre a healthcare worker or you have kidney failure, youll have a follow-up appointment to see if you have responded to the vaccine.
If you have been vaccinated by your employers occupational health service, you can request a blood test to see if you have responded to the vaccine.
Interchangeability And Dosing Schedule
- 2-dose HepB vaccine series only applies when both doses consist of HepB-CpG, administered at least 4 weeks apart.
- Series consisting of a combination of 1 dose of HepB-CpG and a vaccine from a different manufacturer should do the following:
- Adhere to the 3-dose schedule minimum intervals of 4 weeks between dose 1 and 2, 8 weeks between dose 2 and 3, and 16 weeks between dose 1 and 3. However, if HepB-CpG is substituted for dose 2 of HepB-alum, a provider has the option of administering the next dose of HepB-CpG a minimum of 4 weeks from the previous dose for a complete series.
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Facts About Hepatitis B
- Two billion people, or one in three, have been infected with hepatitis B worldwide. Of these, almost 300 million live with chronic hepatitis B. This means about 1 of every 26 people throughout the world are living with a chronic hepatitis B infection.
- Each year about 900,000 people die from hepatitis B worldwide, and about 2,000 of these deaths occur in the United States.
- Hepatitis B is transmitted through blood and is 100 times more infectious than HIV. An estimated one billion infectious viruses are in one-fifth of a teaspoon of blood of an infected person, so exposure to even a very small amount, such as on a shared toothbrush, can cause infection.
- Hepatitis B is sometimes referred to as the silent epidemic because most people who are infected do not experience any symptoms.
- Liver cancer accounted for about 5% of cancer deaths in the U.S. during 2020.
- Almost half of liver cancers are caused by chronic infection with hepatitis B.
- The World Health Organization recommends the inclusion of hepatitis B vaccine in immunization programs of all countries in 2019, more than 8 of 10 infants born throughout the world received three doses of hepatitis B vaccine.
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Does The Hepatitis B Vaccine Have Side Effects
Some children will develop pain or soreness in the local area of the shot, and low-grade fever.
There is one extremely rare, but serious, side effect. About 1 out of every 600,000 doses of the hepatitis B vaccine will cause a severe allergic reaction, called anaphylaxis, with symptoms including swelling of the mouth, difficulty breathing, low blood pressure or shock. Anaphylaxis usually occurs within 15 minutes of receiving the vaccine. Although anaphylaxis can be treated, it is quite frightening. People should remain at the doctors office for about 15 minutes after getting the vaccine.
Although the hepatitis B vaccine is made in yeast cells, no one has ever been shown to be allergic to the yeast proteins contained in the hepatitis B vaccine .
Immunogenicity In Hemodialysis Patients:
Hemodialysis patients given hepatitis B vaccines respond with lower titers,12 which remain at protective levels for shorter durations than in normal subjects. In a study in which patients on chronic hemodialysis received 40 mcg of the plasma-derived vaccine at months 0, 1, and 6, approximately 50% of patients achieved antibody titers 10 mIU/mL.12 Since a fourth dose of ENGERIX-B given to healthy adults at month 12 following the 0-, 1-, and 2-month schedule resulted in a substantial increase in the GMT , a 4-dose regimen was studied in hemodialysis patients. In a clinical trial of adults who had been on hemodialysis for a mean of 56 months , 67% of patients were seroprotected 2 months after the last dose of 40 mcg of ENGERIX-B given on a 0-, 1-, 2-, and 6-month schedule the GMT among seroconverters was 93 mIU/mL.
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Advisory Committee On Immunization Practices
The Centers for Disease Control and Preventions Advisory Committee on Immunization Practices provide recommendations for the hepatitis B vaccine. The following include persons recommended to receive the hepatitis B vaccination :
- Adults aged 60 years and older with risk factors for hepatitis B:
-
Persons at risk for infection by sexual exposure
- Sex partners of persons testing positive for HBsAg
- Sexually active persons who are not in a long-term, mutually monogamous relationship
- Persons seeking evaluation or treatment for a sexually transmitted infection
- Men who have sex with men
Persons at risk for infection by percutaneous or mucosal exposure to blood
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Hepatitis A And B: Diseases Of The Liver
Hepatitis is an inflammation of the liver, most often caused by a viral infection. There are three common types of hepatitis caused by viruses: hepatitis A, hepatitis B, and hepatitis C. Vaccines have been developed that protect people from contracting hepatitis A and B. There is no vaccine for hepatitis C.
Hepatitis A and hepatitis B can be spread from person to person, although in different ways. They have similar symptoms, which include abdominal pain, fever, fatigue, joint pain, and jaundice .
Over the last 20 years, there has been a 90% decrease in cases of hepatitis A and an 80% decrease in hepatitis B cases in the U.S. Health experts believe that immunization efforts have led to this drop in rates of infection.
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Hepatitis B Adult Vaccine Dosing Information
Usual Adult Dose for Hepatitis B Prophylaxis:
Primary Vaccination:Engerix-B:19 years and younger: Three doses intramuscularly on a 0, 1, and 6 month schedule20 years and older: Three doses intramuscularly on a 0, 1, and 6 month scheduleHeplisav-B: Two doses intramuscularly one month apartRecombivax-HB: 19 years and younger: Three doses intramuscularly on a 0, 1, and 6 month schedule 20 years and older: Three doses intramuscularly on a 0, 1, and 6 month schedule Known or Presumed Hepatitis B Exposure:Engerix-B : Use recommended doses of on a 0, 1, and 6 month schedule OR a 0, 1, 2, and 12 month schedule.Recombivax-HB: Refer to recommendations of the Advisory Committee on Immunization Practices
Concurrent Administration Of Vaccines
HB-containing vaccines may be administered concomitantly with other vaccines or with HBIg. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections.
Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
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Babies And Hepatitis B Vaccination
Pregnant women have a routine blood test for hepatitis B as part of their antenatal care.
Babies born to mothers infected with hepatitis B need to be given a dose of the hepatitis B vaccine within 24 hours of their birth, followed by further doses at 4, 8, 12 and 16 weeks of age, plus a final dose when theyre 1 year old.
Babies of mothers identified by the blood test as particularly infectious might also be given an injection of HBIG at birth on top of the hepatitis B vaccination to give them rapid protection against infection.
All babies born to mothers infected with hepatitis B should be tested at 1 year of age to check if they have become infected with the virus.
Many People With Hbv Dont Know They Have It
HBV infections are becoming less common in the United States. But HBV is still widespread in other parts of the world. Around 257 million people living around the world currently have HBV, and many of them dont know it. Chronic HBV is often asymptomatic, and even when it isnt, it can take months for symptoms to show up.
HBV can be transmitted through sexual contact and the use of IV drugs , and other risk factors. Although rare, there
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How To Get Vaccinated Against Hepatitis B
All babies in the UK born on or after 1 August 2017 are given 3 doses of hepatitis B-containing vaccine as part of the NHS routine vaccination schedule.
These doses are given at 8, 12 and 16 weeks of age.
Babies at high risk of developing hepatitis B infection from infected mothers are given extra doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age.
If you think you’re at risk and need the hepatitis B vaccine, ask your GP to vaccinate you, or visit any sexual health or genitourinary medicine clinic.
If your job places you at risk of hepatitis B infection, it’s your employer’s responsibility to arrange vaccination for you, rather than your GP. Contact your occupational health department.
Hepatitis B Vaccine Side Effects
Most people only experience mild, short-term side effects from the hepatitis B vaccine. Common side effects include:
- Pain, redness, or swelling at the site of injection
Severe allergic reactions to the hepatitis B vaccine are very rare. If you have symptoms of an allergic reaction shortly after getting the HepB vaccinesuch as difficulty breathing, facial swelling, or hivesseek medical help immediately.
The hepatitis B vaccine is safe and effective for most people. However, there are certain people who should not get the HepB vaccine, including:
- People who are moderately or severely ill at the time of vaccination
- People who have had a severe allergic reaction to yeast
- People who have had a severe allergic reaction to a hepatitis B vaccine in the past
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Hepatitis B Vaccination Schedule For Children And Infants
The Centers for Disease Control and Prevention recommends that babies and children receive three 0.5 milliliter doses of either Engerix-B or Recombivax HB, starting just after birth.
The current recommended hepatitis B vaccine schedule for children and infants is as follows:
| Hepatitis B Vaccination Schedule for Infants and Children | |
|---|---|
| Hepatitis B Vaccine Dose | |
| 3 | 618 months old |
If your child is undergoing hemodialysis, your healthcare provider may recommend that they receive additional doses of the HBV vaccine.
How Is This Vaccine Given
This vaccine is given as an injection into a muscle. A healthcare provider will give you this injection.
The hepatitis B vaccine is given in a series of 2 to 4 shots. The booster shots are sometimes given 1 month and 6 months after the first shot. If you have a high risk of hepatitis B infection, you may be given an additional booster 1 to 2 months after the third shot.
Your individual booster schedule may be different from these guidelines. Follow your doctor’s instructions or the schedule recommended by the health department of the state you live in.
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More Information On Side Effects
Reactions listed under âpossible side effectsâ or âadverse eventsâ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.
If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency through the Yellow Card Scheme
Us Infant Hepatitis B Vaccine Schedules
*Please note that the first dose should be given as soon as possible. Additional doses require minimum time intervals between doses in order for the vaccine to be effective.
3-Dose Vaccine Series for Infants
Since 1991, ALL medically stable infants with a birth weight of at least 2,000 g in the U.S. are recommended to receive the first dose of hepatitis B vaccine within 24 hours of birth. The additional 2 doses are given at 1 month and 6 months of age.
4-Dose Vaccine Combination Series for Infants
Combination vaccines, such as the pentavalent and hexavalent vaccines, include protection against 5 or 6 diseases, including hepatitis B. The first shot is usually given at 6 weeks of age, but in order to protect infants from hepatitis B beginning at birth, a monovalent or single dose of the hepatitis B vaccine is also recommended within 24 hours of birth. The hepatitis B vaccine series can then be completed with the pentavalent or hexavalent vaccine with the recommended schedule.
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Dosage And Vaccination Schedule
Dosage varies according to age and type of vaccine used: follow manufacturer’s instructions.
Child: one dose = 5 to 10 micrograms
Adult: one dose = 10 to 20 micrograms
- Standard schedule
- Neonate and infant:
- One dose as soon as possible after birth then a 2nd dose at 6 weeks and a 3rd dose at 14 weeks
- One dose as soon as possible after birth then 3 doses administered 4 weeks apart with the 1st at 6 weeks, the 2nd at 10 weeks and the 3rd at 14 weeks
- Child, adolescent, adult: schedule 0-1-6
2 doses 4 weeks apart, then a 3rd dose 6 months after the 1st dose
- Accelerated schedule, when rapid protection is required in the event of post-exposure prophylaxis
3 doses administered during the same month on D0-D7-D21, then a 4th dose one year after the 1st dose
How Is A Hepatitis B Vaccine Given
A health care provider gives the hepatitis B vaccine. The vaccine is given as a shot injected into a muscle, usually in the arm for adults and children older than 1 year and in the thigh for infants and children younger than 1 year. Vaccination with a hepatitis B vaccine is usually given as a series of injections over a period of time, depending on the specific brand of the vaccine. Read any printed information that your health care provider gives you about the hepatitis B vaccine.
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Us Children And Adult Hepatitis B Vaccine Schedules
*Please note that the first dose should be given as soon as possible. Additional doses require minimum time intervals between doses in order for the vaccine to be effective.
3-Dose Vaccine Series for Children and Adults
The hepatitis B vaccine is an injection that is generally given in the arm as a three-dose series on a 0, 1, and 6-month schedule. Alternative schedules may be considered, noting that a third dose at 6 months, meeting minimum intervals between doses, is needed for maximum, long-term protection. Completing the hepatitis B vaccine series, preferably beginning at birth, will ensure protection against hepatitis B, hepatitis delta and lower the lifetime risk of liver cancer. Greater than 90% of babies and up to 50% of young children who are not vaccinated and are infected with hepatitis B will have lifelong infection, which makes the birth dose essential to their protection.
There are four, 3-dose vaccine brands approved in the U.S.
- PreHevbrio PreHevbrio is only approved for adults age 18 and over.
2-Dose Vaccine Series
Emergency Hepatitis B Vaccination
If you have been exposed to the hepatitis B virus and have not been vaccinated before, you should get immediate medical advice, as you may benefit from having the hepatitis B vaccine.
In some situations, you may also need to have an injection of antibodies, called specific hepatitis B immunoglobulin , along with the hepatitis B vaccine.
HBIG should ideally be given within 48 hours, but you can still have it up to a week after exposure.
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What Other Drugs Interact With Hepatitis B Vaccine
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.
- Severe Interactions of Hepatitis B Vaccine include:
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.
What Are The Uses For Hepatitis B Vaccine
Hepatitis B vaccine is used to prevent hepatitis B, a serious infection that affects the liver.
Most children are given their first shot at birth, followed by a 2nd shot at 1-2 months of age, and a 3rd shot at 6-18 months of age. Also, anyone who is 18 years of age or younger and hasnât received the vaccine should be vaccinated.
Additionally, all unvaccinated adults at risk for hepatitis B infection should be vaccinated. This includes:
- Partners or people infected with hepatitis B
- Men who have sex with men
- People who inject street drugs
- People with more than one sex partner
- People with chronic liver or kidney disease
- People under the age of 60 who have type 1 or 2 diabetes
- People with jobs that expose them to human blood or other body fluids
- People who live with a family member infected with hepatitis B
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