Saturday, January 28, 2023

Hepatitis B Vaccine For Newborns

What If I Am Hep B Positive

Why Do Newborns Get the Hepatitis B Vaccine?

The recommendations for women who are Hep B positive are slightly different. Its worth mentioning that most of the women I see who are Hep B positive, both in my private practice and my work in a public hospital, are women who contracted the infection as babies and are now chronic carriers. In the first instance, it is important that these women see someone who specializes in the treatment of viral hepatitis who can provide longterm monitoring of their liver function and treatment if required.

Secondly, as well as receiving the Hep B vaccine within 12 hours of birth, babies of these women also receive a further injection of Hep B immunoglobulin to further reduce the risk that they will prick up the infection. This has been shown to be very effective in preventing transmission it works in up to 95% of cases. These babies will then be followed up by a paediatrician to make sure that they have not contracted the virus.

Women who are Hep B positive can still have a vaginal delivery and are still able to breastfeed. Studies have shown that, providing the vaccination and immunoglobulin are given, neither of these things increase the risk of transmission.

Dr Rachel Ryan MBBS.Hons FRANZCOG108/320 Victoria Pde, East Melbourne VIC 300203 8415 0150

Silent Infections In Hbsag Negative Babies

The six subjects who remained positive for anti-HBc during the follow up were considered to have been infected at birth or during infancy, although the exact time of infection could not be assessed from these results. For the 231 neonates who did become anti-HBc negative during the study, anti-HBc reappeared in 14 blood samples among 6.1% of subjects . Therefore, when considering the number of subjects who were either continuously anti-HBc positive or who had reappearance of anti-HBc, 20 silent infections occurred during the follow up. Five of the 14 anti-HBc reappearances were without a simultaneous anti-HBs rise : one child in group 1 B was positive at months 60 and 61 one child in group 1 NB was positive at months 60, 84, and 96 another in group 2 NB was positive at months 24, 36, 48 and then lost to follow up and the remaining two children were positive at months 36, 60, and subsequently lost to follow up . In the five blood samples from five neonates before the reappearance of anti-HBc, 60% had anti-HBs titres below 100 mU/ml, with a GMT of 75 mU/ml. In the nine neonates who had an anti-HBc reappearance also accompanied by an anti-HBs rise , 78% had anti-HBs titres < 100 mU/ml with a GMT of 36 mU/ml.

Vaccinated neonates experiencing permanent anti-HBc re-emergence without an accompanying rise in anti-HBs

How Common Is Hepatitis B

One U.S. study following trends in hepatitis B infection over a three-year periodfound that 4.3% of the population had a past or present HBV infection.

Estimates suggest that about 240 million people around the world have chronic hepatitis B. Up to 1.89 million people in the United States have a chronic HBV infection.

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Hepatitis B Infection And The Risk To Your Baby

Each year in the UK, around 3,000 babies are born to women who have hepatitis B infection. This infection is caused by a virus that is spread through blood and attacks the liver.

During childbirth, your baby is in contact with your blood so there is a chance that the virus is passed on to your baby. If this happens, your baby could become infected, 9 out of 10 exposed babies will develop chronic infection.

This can lead to liver disease such as scarring of the liver and liver cancer, which stops the liver from working properly.

Hepatitis B infection can be prevented by vaccination.

I Am A Healthcare Worker Who Did Not Develop Hepatitis B Antibodies After Immunization What Should I Do

Hepatitis B Vaccination of Infants, Children, and Adolescents

Two versions of hepatitis B vaccine are available. One, called Heplisav-B, contains a novel adjuvant that was not present in previous versions used by adults . Some people did not respond to the older version hepatitis B vaccine. In fact, in a group of adults younger than 40 years of age who received two doses of the older version vaccine 75 of 100 were protected. Following the third dose, this number increased to 90 of 100. However, people older than 40 years of age were less likely to respond to the vaccine with increasing age. On the other hand, 90 to 100 of 100 adults 18 years of age and older respond to Heplisav-B, which was approved for use in 2018.

About 5-10 of every 100 children and adults younger than 40 years of age do not respond to the third dose of the hepatitis B vaccine. Some of these people will be recommended to get vaccinated again. About 5 of 100 people will still not respond after getting all recommended doses of both series. Note that children younger than 18 years of age cannot get Heplisav-B.

If the people who do not respond to vaccination are determined not to have chronic hepatitis B, they will be reliant on taking precautions to reduce the chance of exposure and relying on those around them for protection. In other words, these people will be reliant on herd immunity.

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Babies That Need To Stay In Hospital

If your baby needs to stay in hospital they should receive the second dose of vaccine when they reach 4 weeks old and then continue to follow the schedule below.

Keep a record of your babys appointments and vaccination dates. These will also be recorded by your midwife, health visitor, practice nurse and GP in your babys Red Book . Bring your childsRed Book to every appointment.

If you have questions you can speak to your midwife, health visitor, practice nurse or GP.

Protecting Your Baby Against Hepatitis B Guide

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Hepatitis B Vaccine: Canadian Immunization Guide

For health professionals

Last partial content update : May 2022

The footnotes in and the accompanying text description for the figure have been revised to align with the corresponding figure in Protocole d’immunisation du Québec, 5e édition from which it was adapted.

Last complete chapter revision :

Why Should My Baby Get The Hepatitis B Shot

Hepatitis B Vaccine for Babies – Importance and Recommended Schedule
  • Protects your child from against hepatitis B, a potentially serious disease.
  • Protects other people from the disease because children with hepatitis B usually dont have symptoms, but they may pass the disease to others without anyone knowing they were infected.
  • Prevents your child from developing liver disease and cancer from hepatitis B.
  • Keeps your child from missing school or child care and you from missing work.

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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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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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Who Should Get The Hepatitis B Vaccine

Any child up to 18 years of age who did not get the vaccine or all of the needed doses should get the vaccine.

  • Your adolescent should get the vaccine if:
  • He or she gets a stick from an infected needle, including for illegal drugs and for procedures such as tattooing
  • He or she has unprotected sex with an infected person, sex with more than one partner, or is a male who has sex with males
  • She is pregnant or breastfeeding and is at risk for hepatitis B
  • Your child or adolescent should get the vaccine if:
  • An object with infected blood or body fluids on it touches a wound
  • He or she has close contact with an infected person
  • He or she travels to an area where hepatitis B is common
  • He or she lives or works in a facility for developmentally disabled persons, long-term care facility, or correctional facility
  • Study Population And Design

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    Prospective mothers who had been pregnant for 67 months were screened for hepatitis B infection markers at the antenatal clinic of Chulalongkorn University in Bangkok, as described in detail elsewhere. All enrolled neonates had a minimum birthweight of 2 kg and a 5 minute Apgar score of at least 7 at birth. The study protocols were approved by the Ethics Committee of the Faculty of Medicine at Chulalongkorn Hospital, and were conducted according to the Declaration of Helsinki and its amendments. Informed consent was given by the parents of the neonates before enrolment into the study.

    The details of the study design are shown in table . The first two studies were open in design. The neonates were vaccinated at birth, then at months 1, 2, and 12 of age. Group 2 NB neonates also received immunoglobulin at birth. The neonates enrolled into the third study were randomised and administered either vaccine only , vaccine only with a booster at month 60 , vaccine with immunoglobulin at birth , or vaccine with immunoglobulin at birth and a vaccine booster at month 60 , all four following initial immunisation at months 0, 1 , and 6 . In all three studies further vaccination of the neonates at month 60 was offered to parents who agreed to return to the study centre with their children at this time. The children were followed up by correspondence with their parents or guardians.

    Protective efficacy against HBsAg chronic carriage for each group, and overall

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    Do The Benefits Of The Hepatitis B Vaccine Outweigh Its Risks

    Every year in the United States about 2,000 people die following an overwhelming hepatitis B virus infection. In addition, every year about 22,000 people are infected with hepatitis B. Some of them will remain chronically infected, putting them at high risk of the long-term consequences of hepatitis B virus infection: cirrhosis and liver cancer. In fact, with the exception of influenza and COVID-19 viruses, hepatitis B virus causes more severe disease and death in the United States than any other vaccine-preventable disease. On the other hand, the hepatitis B vaccine is an extremely rare cause of a severe allergic reaction called anaphylaxis. To date, no one has died from this reaction, but it is theoretically possible that this could occur.

    Because hepatitis B virus is a common cause of severe disease and death in the United States, and because the hepatitis B vaccine does not cause permanent damage or death, the benefits of the hepatitis B vaccine clearly outweigh its risks.

    Hepatitis B Vaccination For Newborns

    It is recommended that all children receive a series of vaccines over the first few years of their lives to protect them from serious infections. One of these is infection with the Hepatitis B virus . Unlike most vaccinations, which start when the baby is six weeks old, the first dose of the Hep B vaccination is given within a few days of birth.

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    Concerns About Immunisation Side Effects

    If the side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your child’s condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital.

    It is important to seek medical advice if you are unwell, as this may be due to other illness, rather than because of the vaccination.

    Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety and reporting service. Discuss with your immunisation provider how to report adverse events in other states or territories.

    Accelerated Us Children And Adult Hepatitis B Vaccine Schedules

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    *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.

    In some instances, it may be necessary to vaccinate within a short period of time to ensure protection before travel. There are accelerated schedules to provide the highest level of protection over a short period of time. Individuals who need an accelerated schedule must have a booster dose at 1 year to ensure long-term protection. Note that the 2-dose Heplisav-B vaccine will also ensure maximum protection over a 1-month period without the need for a booster dose at 1 year.

    4-Dose Vaccine Series for Children and Adults

    Engerix-B is a 3-dose vaccine that can be given on an accelerated, four-dose schedule, with 3 shots administered within 2 months, and a booster dose at 1 year to provide maximum long-term protection.

    4-Dose Combination Hepatitis A and B Vaccine Series

    Twinrix is a 4-dose vaccine that can be given on an accelerated schedule to provide protection against hepatitis A and B. Three doses are administered within 1 month, followed by a booster shot at 1 year. This is a common choice of vaccine for those travelling on short-notice outside the U.S. It is important to complete the booster dose at 1 year, to ensure long-term protection.

    2-Dose Vaccine Series

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    Managing Fever After Immunisation

    Common side effects following immunisation are usually mild and temporary . Specific treatment is not usually required.

    There are a number of treatment options that can reduce the side effects of the vaccine such as giving extra fluids to drink and not overdressing if there is a fever.

    Although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given check the label for the correct dose or speak with your pharmacist, especially when giving paracetamol to children.

    What Is The Hepatitis B Vaccine

    The Centers for Disease Control and Prevention recommends that all babies get the hepatitis B vaccine.

    Since the vaccine protects a person for life, giving your baby the shot at birth and completing the whole series means you’ll never have to worry that your baby will become infected with the hepatitis B virus.

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    What Are The Risks Of Not Getting The Vaccine

    The main risk of the baby not getting the vaccine is that they may contract the hepatitis B virus.

    Hepatitis B primarily attacks the liver, causing inflammation that can damage this organ over time. An acute infection lasts for less than 6 months and may cause no symptoms in some people.

    Many acute infections resolve without treatment. If the infection persists for 6 months or more, doctors will refer to it as chronic. Chronic infections increase a persons risk of damage to the liver over time.

    As this damage builds up, it can scar the liver, which is known as cirrhosis. This long-term damage may result in other complications, including liver cancer.

    According to the WHO, about

    Why We Vaccinate Babies Against Hepatitis B

    Hepatitis B Vaccine for Newborns, Why Itâs Important

    Given the rising number of measles cases, being up to date with your immunizations is very important.

    But there are always questions from concerned parents, including a few raised in a recent letter to my editors at the Gazette, and this seems like a good opportunity to provide some answers.

    First off, why do we vaccinate babies against hepatitis B?

    There is a common perception that hepatitis B is a disease of adults, transmitted via sexual intercourse or needles. If that were the case, vaccinating babies would be nonsensical.

    But the reality is that hepatitis B is a disease that affects many infants and young children worldwide. And unfortunately, the younger you get the virus, the more likely it is to become a chronic infection that can cause cirrhosis or liver cancer. While most diseases are more severe if you get them as an adult, hepatitis B is paradoxically worse if you get it young. Infants less than one year old who get hepatitis B have an 80-90 per cent chance of developing a chronic infection, compared to 30-50 per cent of children under 6 and less than 5 per cent of adults.

    Between 1990 and 2006, the rate of hepatitis B infection fell by 81 per centto the lowest level ever recorded, and the decline was greatest among children. Today, most hepatitis B infections in North America occur in adults. But worldwide, in places where hepatitis B is still common, infections can and do occur very frequently in children.

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