Monday, January 30, 2023

Hepatitis B Vaccine In Infants

Are Hepatitis B Virus Infections Easily Avoided

Why Do Newborns Get the Hepatitis B Vaccine?

Large quantities of hepatitis B virus are present in the blood of people with hepatitis B in fact, as many as one billion infectious viruses can be found in a milliliter of blood from an infected individual. Therefore, hepatitis B virus is transmitted in the blood of infected individuals during activities that could result in exposure to blood, such as intravenous drug use, tattooing, or sex with people who are infected. However, it is also possible to catch hepatitis B virus through more casual contact, such as sharing washcloths, toothbrushes or razors. In each of these cases, unseen amounts of blood can contain enough viral particles to cause infection. In addition, because many people who are infected don’t know that they are infected, it is very hard to avoid the chance of getting infected with hepatitis B virus.

Hepatitis B Vaccine Side Effects

The hepatitis B vaccine is considered a very safe and effective vaccine. Its made with an inactivated virus, so most types of the vaccine are even safe for pregnant people.

The hepatitis B vaccine may cause some mild side effects. The most common symptom is redness, swelling, or soreness where the injection was given. Some people also experience headache or fever. These effects usually last a day or two .

Rarely, some people have a serious and potentially life threatening allergic reaction to the vaccine. Call 911 or get to a hospital immediately if you experience any of the following symptoms after vaccination:

Why Give The Hepatitis B Vaccine To Infants

The CDC recommends a birth dose of the hepatitis B vaccine for all babies. Pediatrician, Dr. Allison Shuman explains why in this informative video.

If you live in a part of the world where chronic HBV is at a medium or high prevalence rate , your child is especially susceptible and at-risk for hepatitis B, with HBV transmission often occurring vertically from mother to child at birth, and horizontally from an HBV infected adult or another childs infected body fluids to an unvaccinated baby or child. Please be sure that pregnant women are screened for hepatitis B. If mom tests positive for HBV, be sure baby receives a birth dose of the HBV vaccine and a shot of HBIG within 12 hours of birth. If mom tests negative for HBV, be sure that baby receives a birth dose of the HBV vaccine before leaving the hospital. Both babies of HBV infected and uninfected moms should receives shots 2 and 3 of the series according to schedule. Babies of infected moms should be tested at 18 months to be sure baby is hepatitis B free.

Please make arrangements with your doctor and the hospital to receive the HBV vaccine for your baby, prior to delivery, so you are sure the vaccine and/or HBIG are available at the hospital so prophylaxis can be given within 12 hours of birth. Please feel free to print and distribute Chronic Hepatitis B in Pregnancy: Screening, Evaluation and Management to your doctor.

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Safety Checks Before Immunization

For Children being immunized at the public health office:

Your nurse will talk to you about your childs health history before giving your child any vaccines. This will include questions about any medicines your child is taking, health conditions your child has or is experiencing, as well as any allergies your child may have. Your nurse will guide you on what is safe for your child, based on your childs health history.

When your nurse talks to you about your childs health history, it is important that you inform your nurse if your child:

  • is sick or has a fever greater than 38.5 C
  • has allergies to any part of the vaccine
  • is allergic to any foods, drugs, bee stings, etc.
  • has a weakened immune system
  • has had an allergic reaction or other severe or unusual reaction to this or other vaccines in the past

Your nurse will guide you on what is safe for your child, based on your childs health history.

For Children being immunized at school:

If you have additional questions about the in-school immunization, you can dial for Health Link, or contact the Public Health Nurse who provides immunizations in your school at the number included in the information package.

What Might My Child Experience After Immunization

A Sydney Hospital Gave Babies A Faulty Hepatitis B Vaccine

The side effects your child may have after immunization depend on which vaccine they received. To find this information, click on the vaccine name in the Routine Immunization Schedule or from the list of Vaccine Information Sheets.

It is rare to have a serious side effect. Call Health Link at 811 to report any serious or unusual side effects.

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Accelerated 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.

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

Additional Resource Links:

Other Reported Adverse Events And Conditions

While serious events and chronic illnesses such as chronic fatigue syndrome, multiple sclerosis, Guillain-Barré syndrome, rheumatoid arthritis and sudden infant death syndrome have been alleged or reported following HB vaccination, no evidence of a causal association has been demonstrated in a number of studies.

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Selected Safety Information For Recombivax Hb Selected Safety Information For Recombivax Hb

Do not administer RECOMBIVAX HB® to individuals with a history of severe allergic or hypersensitivity reactions after a previous dose of any hepatitis B-containing vaccine or to any component of RECOMBIVAX HB, including yeast.

The vial stopper and the syringe plunger stopper and tip cap contain dry natural latex rubber, which may cause allergic reactions in latex-sensitive individuals.

Apnea following intramuscular vaccination has been observed in some infants born prematurely. Decisions about when to administer an intramuscular vaccine, including RECOMBIVAX HB, to infants born prematurely should be based on consideration of the individual infants medical status and the potential benefits and possible risks of vaccination. For RECOMBIVAX HB, this assessment should include consideration of the mothers hepatitis B antigen status and high probability of maternal transmission of hepatitis B virus to infants born to mothers who are HBsAg positive if vaccination is delayed.

Hepatitis B vaccination should be delayed until 1 month of age or hospital discharge in infants weighing < 2000 g if the mother is documented to be HBsAg negative at the time of the infants birth. Infants weighing < 2000 g born to HBsAg positive or HBsAg unknown mothers should receive vaccine and hepatitis B immune globulin in accordance with ACIP recommendations if HBsAg status cannot be determined.

Vaccination with RECOMBIVAX HB may not protect all individuals.

Hepatitis B Vaccine On The Nhs

Hepatitis B Vaccine for Babies – Importance and Recommended Schedule

A hepatitis B-containing vaccine is provided for all babies born in the UK on or after 1 August 2017. This is given as part of the 6-in-1 vaccine.

Hospitals, GP surgeries and sexual health or GUM clinics usually provide the hepatitis B vaccination free of charge for anyone at risk of infection.

GPs are not obliged to provide the hepatitis B vaccine on the NHS if you’re not thought to be at risk.

GPs may charge for the hepatitis B vaccine if you want it as a travel vaccine, or they may refer you to a travel clinic for a private vaccination. The current cost of the vaccine is around £50 a dose.

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How Is The Hepatitis B Vaccine Made

People are protected against hepatitis B virus infection by making an immune response to a protein that sits on the surface of the virus. When hepatitis B virus grows in the liver, an excess amount of this surface protein is made. The hepatitis B vaccine is made by taking the part of the virus that makes surface protein and putting it into yeast cells. The yeast cells then produce many copies of the protein that are subsequently used to make the vaccine. When the surface protein is given to children in the vaccine, their immune systems make an immune response that provides protection against infection with the hepatitis B virus.

The first hepatitis B vaccine was made in the 1980s by taking blood from people infected with hepatitis B virus and separating or purifying the surface protein from the infectious virus. Because blood was used, there was a risk of contaminating the vaccine with other viruses that might be found in blood, such as HIV. Although contamination with HIV was a theoretical risk of the early, blood-derived hepatitis B vaccine, no one ever got HIV from the hepatitis B vaccine. That is because the blood used to make vaccine was submitted to a series of chemical treatments that inactivated any possible contaminating viruses. Today, there is no risk of contaminating the vaccine with other viruses because the surface protein is manufactured in the laboratory.

Benefits Of The Hepatitis B Vaccine

The main benefit of the vaccine is its effectiveness. The AAP says that if a baby receives the first dose within 24 hours of delivery, the vaccine is 7595% effective in preventing hepatitis B transmission from parent to infant.

Additionally, if the newborn also receives the medication HBIG at the correct time with a series of follow-up vaccines, the AAP estimates that the infection rate drops to 0.71.1%.

Therefore, a baby needs to complete the full series of hepatitis B vaccines for the best possible protection.

Research indicates that hepatitis B vaccines are a safe and effective way to prevent hepatitis B infections.

According to the CDC , the vaccine is very safe, and the full series of the vaccine provides the highest possible level of protection from a hepatitis B infection.

Vaccines are subject to constant safety monitoring both during production and once doctors begin to administer them to people. Any signs of a potentially dangerous response to a vaccine would result in immediate recall, meaning they are generally very safe.

While many people misunderstand or misstate the dangers of some aspects of vaccination, there are still possibly severe conditions that doctors may associate with hepatitis B immunizations.

A discusses these possible rare complications. However, it is important to note that these results do not mean that the vaccination causes these conditions instead, there may be an association between them.

Possible conditions include:

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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.

International Hepatitis B Vaccine Schedules

World Immunization Day! Hepatitis B Vaccine
*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

Additional Resource Links:

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Persons With Chronic Diseases

Refer to Immunization of Persons with Chronic Diseases in Part 3 for additional general information about vaccination of people with chronic diseases.

Chronic renal disease and patients on dialysis

People with chronic renal disease may respond sub-optimally to HB vaccine and experience more rapid decline of anti-HBs titres, and are therefore recommended immunization with a higher vaccine dose. Individuals undergoing chronic dialysis are also at increased risk for HB infection. In people with chronic renal disease anti-HBs titre should be evaluated annually and booster doses using a higher vaccine dose should be given as necessary.

Neurologic disorders

People with conditions such as autism spectrum disorders or demyelinating disorders should receive all routinely recommended immunizations, including HB-containing vaccine.

Chronic liver disease

HB immunization is recommended for non-immune persons with chronic liver disease, including those infected with hepatitis C, because they are at risk of more severe disease if infection occurs. Vaccination should be completed early in the course of the disease, as the immune response to vaccine is suboptimal in advanced liver disease. Post-immunization serologic testing may be used to confirm vaccine response.

Non-malignant hematologic disorders

Persons with bleeding disorders and other people receiving repeated infusions of blood or blood products are considered to be at higher risk of contracting HB and should be offered HB vaccine.

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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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 .

Facts About Hepatitis B

Why Are Adults 19 to 59 Recommended to Get the Hepatitis B Vaccine?
  • 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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