How Is It Spread
- Sexual contact with an infected person
- Direct contact with infected blood, including sharing needles to inject drugs or other drug injection equipment that has blood on it
- Sharing personal items, such as toothbrushes, razors, syringes, or glucose monitors that may have blood on them
- Direct contact with open sores of an infected person
- Pregnant women infected with the virus passing it to their babies at birth.
The hepatitis B virus is NOT spread by casual contact such as hugging, or by sneezing, coughing, or sharing food and drinks. Hepatitis B is also not spread by breast feeding.
Is Hepatitis B/hepatitis A Vaccine Safe To Take If I’m Pregnant Or Breastfeeding
There are no adequate studies done on hepatitis A/B vaccine to determine safe and effective use in pregnant women. Hepatitis A/B vaccine should be given to pregnant women only if clearly needed.
NURSING MOTHERS: It is not known whether hepatitis A/B vaccine enters breast milk therefore, it is best to be cautious before using it in mothers who arebreastfeeding.
How Is A Hepatitis B Vaccine Given
A health care provider gives the hepatitis B vaccine. The vaccine is given as a shot injected into a muscle, usually in the arm for adults and children older than 1 year and in the thigh for infants and children younger than 1 year. Vaccination with a hepatitis B vaccine is usually given as a series of injections over a period of time, depending on the specific brand of the vaccine. Read any printed information that your health care provider gives you about the hepatitis B vaccine.
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Hepatitis B Vaccine Schedule For Adults
Hepatitis B is a vaccine-preventable viral disease that involves inflammation of the liver.
The hepatitis B virus usually leads to a short-term infection known as acute hepatitis B. If their infection is left untreated, some people develop chronic hepatitis B. Chronic hepatitis B is a serious, permanent condition that can cause organ damage, cirrhosis , liver cancer, liver failure, and even death.
According to the Centers for Disease Control and Prevention , all people should be vaccinated against hepatitis B starting at birth. Adults who are at risk of developing hepatitis B should also receive the vaccine, which is highly effective in preventing infection.
Read on to learn more about the hepatitis B vaccine for adults, including who should receive it, the details of the dosage schedule, side effects, and more.
Prasit photo / Getty Images
The Safety Of Hepatitis B Vaccination Programs
Numerous clinical trials and widespread practical applications have demonstrated that hepatitis B vaccines are very safe. Since 1982, over 1 billion doses of hepatitis B vaccine have been used worldwide. Adverse events after immunization against hepatitis B are infrequent and generally mild and transient. Except for localized pain, placebo-controlled studies have revealed that reported events occur no more frequently among vaccinees than among persons receiving placebo . Data from numerous long-term studies fail to causally link other serious adverse events to hepatitis B vaccination. Data do not indicate a causal association between hepatitis B vaccine and neurological disease , leukemia, diabetes mellitus, demyelinating disorders, chronic fatigue syndrome, arthritis, autoimmune disorders, asthma, hair loss, or sudden infant death syndrome. The Global Advisory Committee on Vaccine Safety has confirmed the excellent safety profile of hepatitis B vaccine and continues to monitor the safety of this vaccine. Furthermore, hepatitis B vaccination can be administered safely to pregnant women during any trimester of pregnancy and to breastfeeding women. Both low birth weight and premature infants and HIV-positive persons can receive hepatitis B vaccination. Hepatitis B vaccination is contraindicated only for persons with a history of allergic reactions to yeast or any of the vaccines components.
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What Other Drugs Will Affect Hepatitis A And B Vaccine
Before receiving this vaccine, tell the doctor about all other vaccines you have recently received.
Also tell the doctor if you have recently received drugs or treatments that can weaken the immune system, including:
-
steroid medicine
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medicine to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders or
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medicines to treat or prevent organ transplant rejection.
If you are using any of these medications, you may not be able to receive the vaccine, or may need to wait until the other treatments are finished.
This list is not complete. Other drugs may affect hepatitis A and B vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Which Adults Should Be Vaccinated Against Hepatitis B
According to CDC recommendations, adults in the following groups are recommended to receive hepatitis B vaccine:
General
- All people age 18 years and younger.
- Anyone 19 years and older who wants to be protected from hepatitis B.
People at risk for infection by sexual exposure
- Sex partners of people who are hepatitis B surface antigen -positive.
- Sexually active people who are not in long-term, mutually monogamous relationships.
- People seeking evaluation or treatment for a sexually transmitted disease.
- Men who have sex with men.
People at risk for infection by percutaneous or permucosal exposure to blood or body fluids
- Current or recent illegal injection drug users.
- Household contacts of people who are HBsAg-positive.
- Residents and staff of facilities for developmentally challenged people.
- Healthcare and public safety workers with reasonably anticipated risk for exposure to blood or blood-contaminated body fluids.
- People with end-stage renal disease, including predialysis, hemo-, peritoneal- and home-dialysis patients.
Others
- International travelers to regions with intermediate or high levels of endemic HBV infection.
- People with chronic liver disease.
- People with HIV infection.
- People with diabetes who are age 19 through 59 years. For those age 60 and older, clinicians should make a determination of need for
- vaccination based on their patients situation.
In a future issue, we will review the various hepatitis B serologic tests, who needs testing, and when they need it .
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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.
Vaccines For Hepatitis A & B
You may have a family member who has viral hepatitis. Or perhaps you recently saw a news brief about a celebrity who contracted hepatitis A or B. Whatever the reason, you want information about a viral illness that you may not have thought much about. What is viral hepatitis? Are you at risk for it? Do you need viral hepatitis vaccines?
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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
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.
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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
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What Is Hepatitis B
Hepatitis B is a highly contagious liver infection caused by the hepatitis B virus . The infection can range in severity from mild to acute. It may last just a few weeks or become a serious, chronic, and potentially fatal health condition.
The best way to prevent this infection is to get the hepatitis B vaccine. Heres what you need to know.
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Implementing Strategies For Hepatitis B Vaccination
When hepatitis B vaccines became available, strategies for HBV control were initially focused on vaccination of high-risk groups . However, high-risk individuals are mostly difficult to reach and are often infected before vaccination . Consequently, coverage of 3 doses of hepatitis B vaccine remained low in most high-risk groups due to low compliance and logistic reasons . In addition, as many as 30% or more people with acute hepatitis B infection do not have identifiable risk factors and are therefore missed by only a high-risk group approach .
Hence it was clear that an additional global strategy was required as the high-risk strategy made little impact and the global burden of hepatitis B diseases became more and more obvious. Decision makers and health professionals worldwide started to discuss a strategy of universal hepatitis B immunization for a certain age cohort, even in low-endemicity countries. In 1991, the WHOs Global Advisory Group of the Expanded Programme on Immunization recommended that hepatitis B vaccine be integrated into national immunization programs in all countries by 1997 . This 1991 recommendation was endorsed by the World Health Assembly in 1992 . Progressively, it has become more widely used and recommendations for HBV vaccination have been extended in an attempt to achieve maximum protection .
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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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 .
Important Information About Vaccine And Hepatitis B Immunoglobulin Shot Administration
Where available, the hepatitis B birth-dose and HBIG should be administered within 24 hours of birth in order to prevent the transmission of hepatitis B from mother to child. It is very important that the shots be given in opposite limbs, to ensure the highest effectiveness. Please see chart above for more information.
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Why Should I Vaccinate My Newborn Child If I Know That I Am Not Infected With Hepatitis B Virus
Before the hepatitis B vaccine, every year in the United States about 18,000 children were infected with hepatitis B virus by the time they were 10 years old. This statistic is especially important because people are much more likely to develop liver cancer or cirrhosis if they are infected early in life, rather than later in life .
About 9,000 of the 18,000 children infected in the first 10 years of life caught the virus from their mother during birth. However, many young children didn’t catch the disease from their mother. They caught it from either another family member or someone else who came in contact with the child. Because hepatitis B can be transmitted by relatively casual contact with items contaminated with the blood of an infected person, and because many people who are infected with hepatitis B virus don’t know that they have it, it is virtually impossible to be “careful enough” to avoid this infection.
For these reasons, all young children are recommended to receive the hepatitis B vaccine. The best time to receive the first dose is right after birth. This will ensure that the child will be protected as early as possible from catching hepatitis B from people who dont know that they are infected with the virus.
Listen to Dr. Offit explain why newborns get the hepatitis B vaccine by watching this short video, part of the series Talking About Vaccines with Dr. Paul Offit.
What To Do If You Miss A Scheduled Dose
The recommended schedule for the HBV vaccine follows a three-dose pattern, with all doses complete within 6 months. The good news is that if you miss a dose, you dont need to start the series of shots all over.
If you missed getting the second dose 1 month after the first, make an appointment as soon as possible. If you miss the third dose, you should also try to get it as quickly as possible. Keep in mind that the second and third doses
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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.
Hepatitis A And B: Diseases Of The Liver
Hepatitis is an inflammation of the liver, most often caused by a viral infection. There are three common types of hepatitis caused by viruses: hepatitis A, hepatitis B, and hepatitis C. Vaccines have been developed that protect people from contracting hepatitis A and B. There is no vaccine for hepatitis C.
Hepatitis A and hepatitis B can be spread from person to person, although in different ways. They have similar symptoms, which include abdominal pain, fever, fatigue, joint pain, and jaundice .
Over the last 20 years, there has been a 90% decrease in cases of hepatitis A and an 80% decrease in hepatitis B cases in the U.S. Health experts believe that immunization efforts have led to this drop in rates of infection.
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