Tuesday, January 24, 2023

Hepatitis B Vaccine In Adults

What Are The Uses For Hepatitis B Vaccine

Why Are Adults 19 to 59 Recommended to Get the 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

General Information About Vaccination Outside The Us

In developing countries, the pentavalent vaccine, a combination 5-in-one vaccine that protects against five diseases, diphtheria, pertussis, tetanus, Hib and hepatitis B, may be given to babies more than 6 weeks of age, and can be given up to 1 year of age. The first dose is given at 6 weeks, and the second and third doses are given at 10 and 14 weeks of age. The pentavalent vaccine may be made available free of charge with the support of GAVI, the vaccine alliance. Check the GAVI country hub to see the resources and immunizations that may be available:

For babies born to mothers with hepatitis B, waiting for the first dose of the pentavalent vaccine is too late and will NOT protect the baby from vertical or horizontal transmission of hepatitis B. Babies born to a mother with hepatitis B have a greater than 90% chance of developing chronic hepatitis B if they are not properly treated at birth.

WHO recommends the hepatitis B vaccine within 24 hours of birth for ALL babies. Plan ahead and inquire about the availability and cost of the monovalent , birth dose of the vaccine, as it is not a GAVI provided immunization. This is particularly important to women who are positive for hepatitis B.

If you are unsure of your hepatitis B status, please be sure your doctor tests you for hepatitis B!

*WHO does not recommend a birth dose of HBIG, which may not be available in all countries. Talk to your doctor if you have questions.

Page updated September 2022.

How Does The Hepatitis B Vaccine Series Work

The vaccine protects you from the hepatitis B virus by getting your body’s immune system to make antibodies. Those antibodies protect you by fighting off the virus if it ever gets into your body.

Usually, the vaccine is spaced out into three different shots called a hepatitis B vaccine schedule. One month after your first shot, you get the second shot. Six months after your first shot, you get the third shot. If you miss your second or third dose, get it as soon as you remember.

The hepatitis vaccine is super effective. Its worked really well to lower the number of people who get hepatitis B every year.

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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.

Infants Born To Mothers Who Have Hepatitis B: Hepatitis B Vaccine Schedules

Vaccine, Hepatitis B, Adult, 10mcg/mL, SDPF, RECOMBIVAX HB®, 1mL Vial ...
*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.

Protecting Your Baby

Infants born to women with hepatitis B must receive accurate doses of hepatitis B vaccine and hepatitis B immune globulin to ensure complete protection. In order to protect these infants, medications should be given immediately after birth in the delivery room or within the first 12-24 hours of life*.

* See Testing and Treatment During Pregnancy section for details. Please note that testing of all pregnant women for hepatitis B is a global recommendation.

3-Dose Vaccine Series for Infants

The World Health Organization recommends that infants born to hepatitis B positive mothers receive the first dose of the hepatitis B vaccine within 24 hours of birth, and ideally a dose of hepatitis B immunoglobulin . These shots must be followed by the additional vaccine doses given on the recommended schedule. In the U.S., infants should follow a 1 month and 6-month schedule for the additional two doses.

4-Dose Combination Vaccine Series for Infants

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This Vaccine Side Effects

Get emergency medical help if you have signs of an allergic reaction or a severe skin reaction .

You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.

Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.

Hepatitis B adult vaccine may cause serious side effects. Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out

  • seizure-like muscle movements or

  • redness, pain, swelling, or a lump where the shot was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Can Hepatitis B Become Negative

It can happen, especially in older adults after a long period of âinactiveâ hepatitis B infection. About 1 to 3 percent of people with chronic hepatitis B lose HBsAg each year, and about half of all people with chronic infections who live up to age 75 will lose HBsAg, depending on the amount of HBV DNA in their blood.

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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 .

Who Is Eligible For Hepatitis B Vaccination

Addressing Adult Patientsâ Hepatitis B Vaccine Concerns with Dr. Sandra Leal

Hepatitis B vaccination is recommended for people with chronic liver disease and/or hepatitis C who are seronegative for hepatitis B. This is because they may have an increased risk of hepatitis B and/or severe liver disease after hepatitis B. Adult-formulation hepatitis B vaccine should be given in a 3-dose schedule.

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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

  • Persons with current or recent injection drug use
  • Household contacts of persons testing positive for HBsAg
  • Residents and staff members of facilities for persons with developmental disabilities
  • Health care and public safety personnel with reasonably anticipated risk for exposure to blood or blood-contaminated body fluids
  • Persons on maintenance dialysis, including in-center or home hemodialysis and peritoneal dialysis, and persons who are predialysis
  • Persons with diabetes at the discretion of the treating clinician
  • International travelers to countries with high or intermediate levels of endemic hepatitis B virus infection
  • Persons with hepatitis C virus infection
  • Persons with chronic liver disease
  • Persons with HIV infection
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    A Note About Sex And Gender

    Sex and gender exist on spectrums. This article will use the terms, male, female, or both to refer to sex assigned at birth. .

    It is important that infants who are born to females with hepatitis B receive accurate doses of the hepatitis B vaccine. They may also be required to receive hepatitis B immunoglobulin if it is available.

    The WHO also recommends using antiviral prophylaxis to help prevent hepatitis B transmission.

    The table below outlines the two recommended hepatitis B vaccine schedules for infants born to those who have hepatitis B:

    Vaccine series

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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.

    Theres no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.

    And, as its an inactivated vaccine, the risk to the unborn baby is likely to be negligible .

    How Is This Vaccine Given

    Engerix Hepatitis B Vaccine Adult 20 mcg/mL 1 mL SDV, 10/Pk

    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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    Who Should Receive The Hepatitis B Vaccine

    Vaccination is the most reliable way to prevent getting hepatitis B or developing serious related medical complications.

    The CDCs Advisory Committee on Immunization Practices recommends that people in all age groups get the hepatitis B vaccine, including:

    • All infants within 24 hours after birth
    • Children and teens who have not previously been vaccinated against hepatitis B
    • Adults ages 19 to 59
    • Adults ages 60 and older with at least one risk factor for hepatitis B

    Adults over 60 who are not at risk of developing hepatitis B can also receive the HepB vaccine if they choose.

    The Hepatitis B Vaccine

    The hepatitis B vaccine is used to prevent hepatitis B. Its usually provided in three doses.

    The first dose can be taken on a date you choose. The second dose must be taken 1 month later. The third and final dose must be taken 6 months after the first dose.

    Some people may need two or four doses of this vaccine.

    There is also a newer hepatitis B vaccine thats offered in two doses.

    Read Also: Booster For Hepatitis B Vaccine

    What Are Side Effects Of Inactivated Viral Vaccines

    Side effects of inactivated viral vaccines may include the following:

    • Injection site reactions include:
  • Triggering of shingles in pre-exposed individuals
  • Precipitation or aggravation of autoimmune disorders such as multiple sclerosis
  • Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

    Hepatitis B Vaccine: Canadian Immunization Guide

    Dr. Sandra Lealâs Hepatitis B Vaccine Recommendation to Diabetic Adults

    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 :

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    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.

    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.

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    The Centers For Disease Control And Prevention Universally Recommends The Hepatitis B Vaccine For All Adults Up To Age 59 And For Adults 60 And Over At High

    The new recommendation simplifies the previously complex guidelines by eliminating the need to screen for risk factors. Read the full recommendation and clinical guidance here.

    The CDC recommends three actions that healthcare providers should take to implement the new universal recommendation:

    • Offer hepatitis B vaccination to all adults aged 1959 years who have not previously completed vaccination, as well as adults > 60 years with risk factors for hepatitis B or without identified risk factors but seeking protection.

    • Implement standing orders to administer the hepatitis B vaccine as part of routine services to adults who have not completed the vaccine series.

    • Offer hepatitis B vaccination, when feasible, in outreach and other settings in which services are provided to persons at risk for HBV infection .

    Available Hepatitis B Vaccines for Adults

    In the U.S., there are now five vaccines approved by the U.S. Food and Drug Administration for use in adults.

    3-dose Vaccine Brands
    Key Messaging to Promote Universal Adult Hepatitis B Vaccination

    The CDC has shared key messages about why universal adult hepatitis B vaccination is important. The messages listed below can be used to promote the new recommendation among the medical community.

    • Disparities can be reduced with increases in vaccination facilitated by a universal adult recommendation.

    If I Already Have Hepatitis B Can The Vaccine Treat It

    Vaccine, Hepatitis B, Adult, 10mcg/mL, SDPF, RECOMBIVAX HB®, 1mL Vial ...

    No. The hepatitis vaccine prevents hepatitis, but doesnt cure it if you already have it. If you have hepatitis B, there are other treatment options.

    However, if you recently got exposed to the hepatitis B virus and you havent had the vaccine yet, tell your doctor right away. The vaccine and possibly other treatment can reduce your chances of getting hepatitis B if you get it within 2 weeks after you came into contact with the virus. The sooner you seek care after being exposed to hepatitis B, the better, so try to get there right away.

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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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