Hepatitis B Vaccine How Often

Where Is It Found

Hepatitis B prevalence is highest among some sub-Saharan African, East and Southeast Asian, and Pacific island populations but can also be found in high numbers in the Mediterranean countries, parts of Eastern Europe, Africa, and Central and South America. It is important to note that although there is a higher risk in certain countries or regions, Hepatitis B occurs in all countries.

Some people may have a higher risk of contracting Hepatitis B through their occupation, i.e. healthcare workers, police and other emergency services workers, funeral company employees, staff of residential care facilities, tattooists, acupuncturists, people who perform body piercings and sex workers.

Recommended Doses Of Hepatitis B Vaccine

Recommended doses of hepatitis B by vaccine type, age, formulation, dosage and schedule.

Download PDF version formatted for print: Recommended Doses of Hepatitis B Vaccine

* The schedule for hepatitis B is flexible, but minimal intervals and minimum ages need to be observed:

• There should be at least 4 weeks between doses 1 and 2, and at least 8 weeks between doses 2 and 3.
• The minimum interval for the overall series from dose 1 to final dose is 4 months .
• Infants, should receive the final dose of hepatitis B vaccine on or after 6 months of age, otherwise long term immunity may be impacted.

Note:

• Adults who are immunocompromised or on dialysis require a larger dose of hepatitis B vaccine.
• The Engerix-B dose required is 40mcg/2.0mL on a scheduled of 0, 1, 2, and 6 months.
• For Recombivax HB, a special formulation is available. The dose is 40mcg/1.0mL given on a schedule of 0, 1, and 6 months

Combination Vaccines:

When To Delay Or Avoid Hepb Immunization

Doctors delay giving the vaccine to babies who weigh less than 4 pounds, 7 ounces at birth whose mothers do not have the virus in their blood. The baby will get the first dose at 1 month of age or when the baby is discharged from the hospital.

The vaccine is not recommended if your child:

• is currently sick, although simple colds or other minor illnesses should not prevent immunization
• had a serious allergic reaction after an earlier dose of the vaccine or is allergic to baker’s yeast

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Is It Okay To Get An Extra Dose Of Hepatitis B Vaccine

Yes. Although extra doses of vaccine are not recommended, you can think of the extra dose as another chance for the immune system to see the hepatitis B virus. A vaccine is not the only time the immune system will see the virus or bacteria contained in it. People may be exposed to the virus or bacteria at school or the store or when visiting family or friends. An extra dose of vaccine is like one more exposure, except the difference is that the virus or bacteria in any vaccine has been made safe, so it wont make you ill.

Persons New To Canada

Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. In many countries outside of Canada, HB vaccine is in limited use.

All persons from a country that is endemic for HB should be assessed and vaccinated against HB if not immune and not infected. Individuals born in developing countries are more likely to be carriers of HB, necessitating vaccination of their sexual and household contacts based on review of their serologic test results. HB vaccine is recommended for all household contacts whose families have immigrated to Canada from areas in which there is a high prevalence of HB and who may be exposed to HB carriers through their extended families or when visiting their country of origin.

Children adopted from countries in which there is a high prevalence of HB infection should be screened for HBsAg and, if positive, household or close contacts in the adopting family should be immunized before adoption or as soon as possible thereafter. Adults going to pick-up children from these countries should be vaccinated before departure. Refer to Immunization of Persons New to Canada in Part 3 for additional information.

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How Long Are You Protected

Unfortunately, it is still hard to pinpoint the precise duration of the hep A vaccine. On the bright side, children who received a three-dose vaccine and adults who received a two-dose vaccine should be safe for 20 years.

In addition, some studies suggest that the vaccine antibodies may be present for forty or more years. This is particularly true for vaccinated children.

So, it is obvious that the vaccine may last for quite a while. However, you should still get a better understanding of the infection itself and the revaccination requirements.

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Dose And Administration Of Hepatitis B Vaccine

The dose for Engerix-B and Recombivax HB is 0.5 mL IM up to age 20 years or 1 mL IM for adults . The dose for HepB-CpG is 0.5 mL IM for adults 18 years.

The vaccine is typically given to children in a 3-dose series at age 0 months, at 1 to 2 months, and at 6 to 18 months.

Infants who did not receive a dose a birth should begin the series as soon as feasible.

All children not previously vaccinated with HepB vaccine should be vaccinated at age 11 or 12 years. A 3-dose schedule is used the first and second doses are separated by 4 weeks, and the third dose is given 4 to 6 months after the second dose. However, a 2-dose schedule using Recombivax HB can be used the second dose is given 4 to 6 months after the first.

Adults age 19 through 59 years who have not been previously vaccinated should complete a 2- or 3-, or 4-dose series. The usual schedule for adults using Engerix-B or Recombivax HB is a 3-dose series with 2 doses separated by 4 weeks, and a third dose 4 to 6 months after the second dose. HepB-CpG is given in 2 doses at least 4 weeks apart and can be given as a substitute in a 3-dose series with a different HepB vaccine.

HepB-CpG should not be given during pregnancy because safety data are not available on its use during pregnancy.

Unvaccinated adults who are being treated with hemodialysis or who are immunocompromised should be given 2 doses of Engerix-B 20 mcg/mL given simultaneously in a 4-dose schedule at 0, 1, 2, and 6 months.

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Compliance With Accelerated Vs Standard Vaccination Schedules In Different Populations

Table 2Overview of hepatitis B vaccine uptake according to vaccination schedule, in different atrisk populations

*Schedule expressed in months 0 1/4 3/4 therefore corresponds to 0.7.21days type of vaccination schedule: coded as S , SS , A or SA parentheses indicate schedules without the final dose numbers and percentages either reported in the paper, or calculated from the reported values

SW/MSM/Multiple partners/STI clinic attendants

Several studies have reported being able to administer three doses of hepatitis B vaccine to a higher proportion of the population targeted, when an accelerated or a superaccelerated schedule was used, at least the primary part of it. Unfortunately, few of these studies report immunogenicity data this is mainly due to the difficulties to administer three vaccine doses, and thus the low proportion that can actually be tested afterwards.39,40,41,42,43,44,45,46

A recent paper that did report immunogenicity data studied a shortened standard schedule as an alternative option, in a setting where other strategies are used to improve the compliance. Even if the 0.1.4months schedule failed to significantly improve the compliance, it offered equal protection within a shorter interval.47

Drug users

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 they’re 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.

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This Research Gets The World A Step Closer To A Hepatitis C Vaccine

Using a Nobel Prize-winning technique called cryo-EM, researchers were able to identify potential areas on the hepatitis C virus that a vaccine could target.

• 2 December 2022

The hepatitis C virus, or HCV, causes a chronic liver infection that can lead to permanent liver scarring and, in dire cases, cancer. It affects around 71 million people worldwide and causes approximately 400,000 deaths each year. While treatments are available for HCV-related infections, they are expensive, hard to access and do not protect against reinfection. A vaccine that can help prevent HCV infection is a major unmet medical and public health need.

One major reason there hasnt been an HCV vaccine yet is that scientists have yet to identify the proper antigen, or the part of the virus would trigger a protective immune response in the body.

Decades of research have pinpointed HCV E1E2, the only protein on the surface of the virus, as the most promising vaccine candidate. However, developing an HCV vaccine based on that protein is limited by uncertainty around what it looks like. Knowing the structure of the protein is necessary to figure out how the immune system responds to the virus.

So how do researchers capture the structure of single protein on a shape-shifting virus?

This is how we did it.

If The Vaccine Does Not Work For Me What Can I Do To Protect Myself And Others Against Hepatitis B

If the vaccine does not work for you, your doctor might offer you further doses of the vaccine. If blood tests then show that you still do not have immunity to hepatitis B you should reduce your risks of being exposed to hepatitis B by:

• practicing safe sex
• washing hands after touching blood or body fluids
• wearing disposable gloves if giving someone first aid, or cleaning up blood or body fluids
• not sharing toothbrushes, razors, needles, syringes, personal hygiene items and grooming aids or any object that may come into contact with blood or body fluids
• using new and sterile injecting equipment for each injection
• covering all cuts and open sores.

If you do get exposed to the hepatitis B virus then you will need to be given hepatitis B immunoglobulin by your doctor as soon as possible.

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How Do You Catch Hepatitis B Virus

Blood from a person infected with hepatitis B virus is heavily contaminated with the virus. As a result, contact with blood is the most likely way to catch hepatitis B. Even casual contact with the blood of someone who is infected can cause infection.

Healthcare workers are at high risk of catching the disease, as are intravenous drug users and newborns of mothers infected with the virus. Sexual contact can also expose people to infection. The virus is also present in low levels in saliva.

How Do I Know That I Am Protected Against Hepatitis B

If you have never been tested for hepatitis B, your doctor can arrange a blood test to check your hepatitis B status before you are given the vaccination course. The prescreening blood test will check you have not already had exposure to the hepatitis B virus.

If you have had a full course of hepatitis B vaccination in the past then there is a good chance that you are protected now. Also, if you have had hepatitis B before and cleared the infection you are immune to hepatitis B.

After vaccination, a post vaccination blood test is available to check that the vaccine has been effective. Your doctor can order this test for you. This blood test is not routinely recommended for children as the hepatitis B vaccine is highly effective.

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Preparations Of Hepatitis B Vaccine

Hepatitis B vaccine is produced using recombinant DNA technology. A plasmid containing the gene for hepatitis B surface antigen is inserted into common bakers yeast, which then produces HBsAg. The HBsAg is harvested and purified. This vaccine cannot cause hepatitis B virus infection because no potentially infectious viral DNA or complete viral particles are produced during this process.

Several vaccines are available. Two single-antigen vaccines, Engerix-B and Recombivax HB, are conjugated with aluminum. A newer formulation, HepB-CpG, uses the immune-stimulating adjuvant, cytidine-phosphate-guanosine oligodeoxynucleotide . A combination formulation that combines hepatitis A and hepatitis B vaccines is available.

What Is Hepatitis B Virus

Hepatitis B virus attacks the liver. Hepatitis B virus infections are known as the “silent epidemic” because many infected people don’t experience symptoms until decades later when they develop hepatitis , cirrhosis , or cancer of the liver . Every year in the United States about 22,000 new hepatitis B infections occur and about 2,000 people die from their infections.

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Who Should Be Immunised Against Hepatitis A

Travellers to countries outside Western Europe, North America and Australasia should consider being immunised. The highest-risk areas include the Indian subcontinent , Africa, parts of the Far East , South and Central America and the Middle East. Vaccination is generally recommended for anyone over the age of 1 year. Your doctor or practice nurse can advise if you should be immunised against hepatitis A for your travel destination.

You can find out if immunisation against hepatitis A is recommended for any countries you are planning to visit from the NHS website Fitfortravel.

Close contacts of someone with hepatitis A. Occasional outbreaks of hepatitis A occur in the UK within families or in institutions. Close contacts of someone found to have hepatitis A infection may be offered vaccination. This only happens rarely. The most important measure for anybody with hepatitis A is good personal hygiene. In particular, washing hands after going to the toilet or before eating.

People with chronic liver disease. If you have a persistent liver disease it is suggested that you have the hepatitis A vaccine. Hepatitis A infection is not more common in those with chronic liver disease but, if infection does occur, it can cause a more serious illness.

People exposed to hepatitis A at work. For example, laboratory workers who are exposed to hepatitis A during their work and sewage workers are advised to be immunised against hepatitis A.

The Hepatitis B Vaccine And Immunosuppressants

If you are taking or about to start taking a medication that suppresses your immune response, let your healthcare provider know. Immunosuppressants may make certain vaccines less effective. Your healthcare provider may recommend that you get the hepatitis B vaccine at a particular time during your course of medication.

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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.

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

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