Who Should Get Immunised Against Hepatitis B
Anyone who wants to protect themselves against hepatitis B can talk to their doctor about getting immunised.
Hepatitis B immunisation is recommended for:
People under 20 years old, refugees and other humanitarian entrants of any age, can get hepatitis B vaccines for free under the NIP. This is if they did not receive the vaccines in childhood. This is called catch-up vaccination.
What To Think About
If you are exposed to HBV before you have received all three shots in the vaccination series, a dose of hepatitis B immune globulin usually will prevent infection until the vaccine takes effect.
If you have already had hepatitis B and have developed protective antibodies to the virus, you do not need the vaccine because you have lifetime protection against the infection. If you are not sure whether you have had hepatitis B, you can be tested, or you can be vaccinated without testing. The vaccine is not harmful for you if you are already immune.
If you have chronic HBV infection, the vaccine will be ineffective, although it is not harmful.
The vaccine is safe for women who are pregnant or breastfeeding.
How Do You Get The Vaccine
- A nurse or doctor will give you a needle in your arm or leg.
- When given alone, it is most common to get the vaccine in 3 doses over a 6-month period. The second dose is given 1 month after the first. The third is given 5 months after the second.
- When given as the 6-in-1 vaccine, 3 doses are given starting at 2 months of age. The last dose may be given at 6 months or at 18 months.
- The combined hepatitis A and B vaccine is good for people who are traveling. It is sometimes used in some school immunization programs. Children under 1 year of age should not be given the combination vaccine.
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Who Should Get The Vaccine
- Newborns of mothers who have hepatitis B.
- All children before or in early adolescence. In some provinces and territories it is given to everyone during infancy. In others, it is given at school. Find out when your province offers the vaccine. In places where vaccine is not given in infancy, some children should not wait for the school program and should get the shot as soon as possible. These include:
- Everyone living in a house with someone with hepatitis B .
- All children whose families have immigrated from areas with high rates of hepatitis B.
- Children living in Canadian communities with high rates of hepatitis B, unless they are already immune.
- Children with conditions that require frequent blood transfusions or blood products, those who are on hemodialysis , or those who have chronic liver disease.
- Children with some conditions that weaken their immune systems.
- Children who are traveling to countries where there is a high rate of hepatitis B.
The Duration Of Protection And The Need For Booster Doses
In vaccine efficacy studies, immunocompetent children and adults who developed anti-HBs concentrations of 10 mIU/mL or higher after vaccination had complete protection against both acute disease and chronic infection for decades , even if subsequently, over time, anti-HBs concentrations declined to less than 10 mIU/mL . Indeed, the protective efficacy of hepatitis B vaccination is related to the induction of anti-HBs antibodies, but it also involves the induction of memory B and T cells. Ongoing surveillance of vaccinees is required to clarify whether hepatitis B vaccination can confer longer, or even lifelong, protection . Based on currently available scientific evidence, different advisory groups do not recommend routine booster doses of hepatitis B vaccine in immunologically competent persons who have received a full primary course, because the majority of previously vaccinated people with an anti-HBs antibody concentration of 10 mIU/mL or less mount an anamnestic response when they receive a booster dose or are exposed to HBV, indicating that they remained protected by memory B and T cells .
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When To Delay Vaccinating
Although the Hepatitis B Foundation stresses that parents should not voluntarily delay vaccinating their babies against hepatitis B, there are situations in which doctors may choose to delay the vaccination.
For instance, sometimes the hepatitis B vaccination is delayed if a baby is premature, has a low birth weight, or is medically challenged.
The CDC’s report, Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, says that all healthy newborns who weigh more than 4.4 pounds should receive the hepatitis B vaccination.
Still, parents always have the option to refuse a vaccination if they want to. But the risks associated with a hepatitis B infection far outweigh the risks of the vaccine.
Moving To Another Country
If you are moving abroad before your baby is one year old, please let your GP know and dont forget to register your baby with a new family doctor in your new country of residence.
Take your babys Red Book with you and make sure your baby receives all of the doses of hepatitis B vaccines on time and has a blood test at 12 months old.
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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 you’re a healthcare worker or you have kidney failure, you’ll have a follow-up appointment to see if you have responded to the vaccine.
If you have been vaccinated by your employer’s occupational health service, you can request a blood test to see if you have responded to the vaccine.
What Is The Morphology Of Hbv
HBV is an oncogenic DNA virus that belongs to the Hepadnaviridae family. The discovery of the etiologic agent of hepatitis B remains a remarkable scientific achievement. It was discovered in 1965 by Dr Blumberg, who won the Nobel Prize in Medicine for his discovery in 1976 . HBV virus, initially called the Dane particle, is a 42-nm virus . HBV is composed of a nucleocapsid core, surrounded by an outer lipoprotein coat . The virus contains 3 primary structural antigens: surface , core , and e . HBsAg is produced in excess amounts and found in the blood of infected individuals in the form of spherical and tubular particles . These immunogenic, but noninfectious, subviral particles lack genomic DNA and paved the way to develop hepatitis B vaccines . HBV is divided into 4 major phenotypic subtypes based on antigenic epitopes presented on its envelope proteins, and comprises 10 major genotypes that differ at the nucleotide level across full-length genotypes by> 8% . The HBV genotypes have distinct virological characteristics and geographical distributions however, the licensed HBV vaccines are effective against all genotypes .
A, Electron micrograph of hepatitis B virus : Dane particles and spherical and tubular surface antigen particles . Source: Centers for Disease Control and Prevention. As a work of the U.S. federal government. B, A simplified figure of the HBV particle and surface antigens.
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Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.
Refer to Reporting Adverse Events Following Immunization in Canada and Adverse events following immunization in Part 2 for additional information about AEFI reporting.
What Is The Transmission Route Of Hbv
Today, we know that HBVs are highly infectious and are spread by exposure of mucosal membranes or nonintact skin to infected blood or other body fluids . In high endemic areas, HBV is most commonly transmitted from mother to child at birth and during early childhood from infected to uninfected children . Most HBV infections in areas of low endemicity occur in adults in relatively well-defined risk groups, such as those at risk through sexual exposure, household members of an infected person, hemodialysis patients, incarcerated persons, injection-drug users, persons at risk for occupational exposure, developmentally disabled persons in long-term care facilities, and travelers to regions with moderate or high HBV endemicity. Today, only humans are a known reservoir for human HBV genotypes, but closely related HBV genotypes exist in higher primates . Hence, a comprehensive control strategy could eventually lead to the eradication of HBV.
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Hepatitis B Immunisation Service
Hepatitis B vaccines are given as a needle, either on their own or as a combination vaccine. They can be provided by a variety of recognised immunisation providers. If you’re eligible, you can get the hepatitis B vaccine for free under the National Immunisation Program .
Find information that will help you deliver your service to your patients
What Is Hepatitis B Vaccine
Hepatitis B is spread through blood or bodily fluids, sexual contact, and by sharing items such as a razor, toothbrush, or IV drug needle with an infected person. Hepatitis B can also be passed to a baby during childbirth when the mother is infected.
The hepatitis B pediatric vaccine is used to help prevent this disease in children and teenagers.
The vaccine helps your child’s body develop immunity to hepatitis B, but will not treat an active infection the child already has.
Vaccination with hepatitis B pediatric vaccine is recommended for all children beginning at birth, especially children and adolescents who are at risk of getting hepatitis B. Risk factors include: living with someone infected with hepatitis B virus being born to a mother who is infected with hepatitis B being on dialysis living in a facility for developmentally disabled people traveling to areas where hepatitis B is common being an adolescent who has never received a hepatitis B vaccine during childhood.
Like any vaccine, the hepatitis B vaccine may not provide protection from disease in every person.
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Interchangeability Of Hepatitis B Vaccines
The Engerix-B and H-B-Vax II vaccines are manufactured by different processes, and the hepatitis B surface antigen content of an equivalent dose of these vaccines is different. Switching vaccine brands is not recommended.
If the brand of vaccine used for previous doses is not known, use another age-appropriate equivalent dose brand. See:
For example, a study in healthy neonates showed comparable high levels of immunogenicity between 2 different mixed regimens that used 2 monovalent hepatitis B vaccines from different manufacturers.33
Hepatitis B Vaccination In Pregnancy
Hepatitis B infection in pregnant women may result in severe disease for the mother and chronic infection for the baby.
This is why the hepatitis B vaccine is recommended for pregnant women who are in a high-risk category.
There’s no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.
And, as it’s an inactivated vaccine, the risk to the unborn baby is likely to be negligible .
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Why It Is Used
Hepatitis B virus causes a liver infection that can lead to serious complications, including liver cancer. It is common in people throughout the world, particularly in Asia and sub-Saharan Africa.
The Canadian National Advisory Committee on Immunization recommends hepatitis B immunization for all children. Pregnant women and other adults who do not have immunity and who have a high chance of exposure should be vaccinated.
The Impact Of Worldwide Hepatitis B Vaccination Programs: Model Of Success
A, Immunization coverage with third dose of hepatitis B in infants in 2019. B, Global immunization 19892019 HepB3 coverage in infants. Global coverage was 84% in 2019. Abbreviations: AFR,African region AMR,Americas region EMR,Eastern Mediterranean region EUR,European region SEAR,South-East Asia region WPR,Western Pacific region. Source: United Nations Children’s Fund /World Health Organization.
The success of HBV vaccination programs has been clearly demonstrated over the recent years in several regions around the world. Countries that have adopted the recommendation had a marked reduction in carrier rates as well as complications from HBV, including HCC. The low prevalence of chronic HBV infection in children younger than 5 years, reducing from 4.7% in the prevaccine era to less than 1% in 2019, can be attributed to the widespread use of hepatitis B vaccine. Due to the implementation of routinely birth-dose vaccination the greatest decrease appears to be in the Western Pacific region, from 8.3% HBsAg prevalence in the prevaccine era to 0.93% in 20022015 . Among health care workers, hepatitis B vaccination is highly effective for the prevention of healthcare associated HBV infection and chronic infection. Using mathematical models, it was estimated that since their implementation, HBV vaccination programs have averted 210 million new HBV infections globally .
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What Is Hepatitis B
Hepatitis B is a contagious liver disease caused by the hepatitis B virus. When a person is first infected with the virus, he or she can develop an acute infection. Acute hepatitis B refers to the first 6 months after someone is infected with the hepatitis B virus. This infection can range from a very mild illness with few or no symptoms to a serious condition requiring hospitalization. Some people are able to fight the infection and clear the virus.
For others, the infection remains and is chronic, or lifelong. Chronic hepatitis B refers to the infection when it remains active instead of getting better after 6 months. Over time, the infection can cause serious health problems, and even liver cancer.
Why Should My Newborn Get The Hepatitis B Vaccine
What is hepatitis B?
Hepatitis B is a liver disease caused by the hepatitis B virus. It is spread when a person comes in contact with the blood or bodily fluids of an infected person. The virus can enter the body through cuts or bites on the skin or through unprotected sex with an infected person.
Newborns can get hepatitis B during birth if the mother is infected. However, many people who get the virus dont know the source of infection. If left untreated, chronic infection can cause serious long-term consequences, including permanent liver damage and liver cancer. Infants and children are much more likely to develop these serious complications than adults.
Why get vaccinated?
The hepatitis B vaccine series consists of three doses that provide long-term protection from hepatitis B infection and its consequences. The vaccine is very effective and has drastically reduced the number of hepatitis B infections since it was first recommended for all children in 1991. Since then, new hepatitis B infections have dropped by more than 95 percent. Plus, this is one of just two vaccines that have proved effective in preventing cancer!
When should my newborn get vaccinated?
The American Academy of Pediatrics recommends the first dose of hepatitis B vaccine at birth. It is the only vaccine routinely recommended at birth because:
Infants who get a birth dose of hepatitis B vaccine are more likely to complete the vaccine series.
What are the risks of the hepatitis B vaccine?
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International 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.
The hepatitis B vaccine is an injection that is generally given in the arm and as a three-dose series. The World Health Organization recommends a 0, 1, and 6-month vaccine schedule, though schedules may vary based on a countrys national immunization program. 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. Please note that the vaccine brand name, manufacturer and associated schedules for adults, children and infants may be unique to different countries, though there is a list of WHO prequalified vaccines.
3-Dose Vaccine Series for Infants
The World Health Organization recommends all infants receive the first dose of the hepatitis B vaccine within 24 hours of birth and to complete the vaccine series with additional shots at 1 month and 6 months of age. Beginning the hepatitis B vaccine at birth will ensure protection against hepatitis B for life.
3-Dose Vaccine Series for Children and Adults
4-Dose Combination Vaccine Series for Infants
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How Hepatitis B Spreads
Because hepatitis B is transmitted from person to person through blood and other body fluids, it is a sexually transmitted infection , but people can get the virus from casual contact with others as well, like sharing a razor or using the wrong toothbrush. Even a bite from an infected child can spread the infection.
Newborns are at high risk of getting hepatitis B through childbirth from mothers who are already infected with the virus. What’s more, they can get the virus regardless of whether they are born vaginally or through a c-section. Unfortunately, even children born to a mother who doesn’t have hepatitis B are at risk because the infection spreads so easily from person to person.
It’s impossible to tell if someone has hepatitis B just by looking at them. In fact, most people with hepatitis B have no symptoms, don’t feel sick, and are unaware that they even have the illness. Consequently, they can spread the virus to other people without even knowing it.
The only way to know if someone has hepatitis B is through a blood test. And once people find out that they have it, it’s often in the advanced stages. Even if it is caught early, there is very little that can be done medically for people with the disease. In fact, the younger a person is when they become infected, the more likely they are to have lifelong liver problems.
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