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.
Origin Of Antiviral Resistance
The genetic makeup of viruses is constantly changing, which can cause a virus to become resistant to currently available treatments. Viruses can become resistant through spontaneous or intermittent mechanisms throughout the course of an antiviral treatment. Immunocompromised patients, more often than immunocompetent patients, hospitalized with are at the highest risk of developing oseltamivir resistance during treatment. Subsequent to exposure to someone else with the flu, those who received oseltamivir for “post-exposure prophylaxis” are also at higher risk of resistance.
Multiple strains of one virus can be present in the body at one time, and some of these strains may contain mutations that cause antiviral resistance. This effect, called the , results in immense variation in any given sample of virus, and gives the opportunity for natural selection to favor viral strains with the highest fitness every time the virus is spread to a new host. Also, recombination, the joining of two different viral variants, and , the swapping of viral gene segments among viruses in the same cell, play a role in resistance, especially in influenza.
Antiviral resistance has been reported in antivirals for herpes, HIV, hepatitis B and C, and influenza, but antiviral resistance is a possibility for all viruses. Mechanisms of antiviral resistance vary between virus types.
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 youâre 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, itâs your employerâs responsibility to arrange vaccination for you, rather than your GP. Contact your occupational health department.
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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.
Emergency Hepatitis B Vaccination
If you have been exposed to the hepatitis B virus and have not been vaccinated before, you should get immediate medical advice, as you may benefit from having the hepatitis B vaccine.
In some situations, you may also need to have an injection of antibodies, called specific hepatitis B immunoglobulin , along with the hepatitis B vaccine.
HBIG should ideally be given within 48 hours, but you can still have it up to a week after exposure.
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Treatment Options For Antiviral Resistant Pathogens
If a virus is not fully wiped out during a regimen of antivirals, treatment creates a bottleneck in the viral population that selects for resistance, and there is a chance that a resistant strain may repopulate the host. Viral treatment mechanisms must therefore account for the selection of resistant viruses.
The most commonly used method for treating resistant viruses is combination therapy, which uses multiple antivirals in one treatment regimen. This is thought to decrease the likelihood that one mutation could cause antiviral resistance, as the antivirals in the cocktail target different stages of the viral life cycle. This is frequently used in retroviruses like HIV, but a number of studies have demonstrated its effectiveness against influenza A, as well. Viruses can also be screened for resistance to drugs before treatment is started. This minimizes exposure to unnecessary antivirals and ensures that an effective medication is being used. This may improve patient outcomes and could help detect new resistance mutations during routine scanning for known mutants. However, this has not been consistently implemented in treatment facilities at this time.
Can I Still Get Hepatitis B Even If I Was Vaccinated
The good news is that hepatitis B is vaccine preventable. This means that after you complete the vaccine series, you cannot contract hepatitis B through any modes of transmission you are protected for life!
What does HEP B vaccine protect against?
The hepatitis B vaccine is given to prevent the severe liver disease that can develop when children or adults are infected with hepatitis B virus.
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Why Is The Hepatitis B Vaccine Important
Because of the vaccine, cases of acute hepatitis B have decreased by a lot in the United States. But chronic hepatitis B is still common up to 2.2 million people in the United States have it. Chronic hepatitis B can lead to serious liver problems and even death.
Getting vaccinated is the best way to prevent hepatitis B.
Hepatitis B is a liver disease caused by a virus. There are 2 types of hepatitis B:
- Acute hepatitis B
- Chronic hepatitis B
Many children who get acute hepatitis B dont have any symptoms, but most adults do. Symptoms may include:
- Dark pee or clay-colored poop
- Pain in the muscles, joints, and stomach
Acute hepatitis B symptoms usually last a few weeks but they can last as long as 6 months.
If the acute hepatitis B infection does not go away after 6 months, its considered a chronic hepatitis B infection. Most people who have chronic hepatitis B dont have symptoms at first. But chronic hepatitis B is a lifelong illness that can lead to serious and possibly deadly liver problems, like:
- Has sex with a person who has hepatitis B
- Touches the blood or open sores of a person who has hepatitis B
All children and most adults need to get the hepatitis B vaccine.
Infants and children
All children need to get the hepatitis B vaccine as part of their routine vaccine schedule.
Children need 3 doses of the vaccine at the following ages:
- Birth for the first dose
- 1 through 2 months for the second dose
- 6 through 18 months for the third dose
For Adults And Children
This vaccine schedule involves three doses within 2 months, followed by a booster dose at 1 year.
The initial accelerated doses provide immediate protection from HBV, and the booster dose helps provide long-term protection.
Below is the accelerated vaccination schedule approved for both adults and children:
|2 months after the first dose
|1 year after the first dose
Dose And Administration Of Hepatitis B Vaccine
The dose for Engerix-BÂ® and Recombivax HBÂ® is 0.5 mL IM up to age 20 years or 1 mL IM for adults . The dose for Heplisav-BÂ® 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 1st and 2nd doses are separated by 4 weeks, and the 3rd dose is given 4 to 6 months after the 2nd dose. However, a 2-dose schedule using Recombivax HBÂ® can be used the 2nd dose is given 4 to 6 months after the first.
The usual schedule for adults using Engerix-BÂ® or Recombivax HBÂ® is a 3-dose series with 2 doses separated by 4 weeks, and a 3rd dose 4 to 6 months after the 2nd dose. Heplisav-BÂ® 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. Heplisav-BÂ® 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 1 dose of Recombivax HBÂ® 40 mcg/mL in a 3-dose schedule at 0, 1, and 6 months or 2 doses of Engerix-BÂ® 20 mcg/mL given simultaneously in a 4-dose schedule at 0, 1, 2, and 6 months.
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Hepatitis B Vaccine On The Nhs
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 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.
How Safe Is The Hepatitis B Vaccine
The hepatitis B vaccine is totally safe for most people. Most babies, kids, and adults have no problems at all when they get the vaccine. In fact, more than 100 million people in the U.S. have gotten the hepatitis B vaccine.
Like all medicines, the hepatitis B vaccine may have some mild side effects: soreness, change in skin color, swelling, or itching around where you get the shot, or a slight fever. But these things arent serious and usually go away pretty quickly. Theres an extremely small risk of having an allergic reaction to the vaccine.
If you get dizzy, feel your heart beating really fast, have a high fever, feel weak, break out in hives, or have trouble breathing, get medical help right away. But again, the risk of having an allergy is super small.
You CANT get hepatitis from the hepatitis vaccine.
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What Are The Side Effects
The most common of the hepatitis B vaccine are mild and include:
- Sore arm from the shot.
Prepare for your child’s vaccine visit and learn about how you can:
- Research vaccines and ready your child before the visit
- Comfort your child during the appointment
- Care for your child after the shot
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 .
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Concurrent Administration Of Vaccines
HB-containing vaccines may be administered concomitantly with other vaccines or with HBIg. Different injection sites and separate needles and syringes must be used for concurrent parenteral injections.
Refer to Timing of Vaccine Administration in Part 1 for additional information about concurrent administration of vaccines.
What About The Hepatitis B Vaccine
The best way to prevent Hepatitis B is to get vaccinated. The Hepatitis B vaccine is now given to most babies at birth, but many adults have not had it. A member of our CVS pharmacyÃÂ® team or a MinuteClinicÃÂ® provider can talk with you about your risk for getting Hepatitis B and answer your questions about the vaccine. They can also administer the vaccine if you decide it is right for you.
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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.
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.
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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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
Routine Administration Schedule For Hepatitis B Vaccine In Adults
- The dosing schedule is 0, 1 to 2 months, and 4 to 6 months.
- There is some flexibility in the schedule, but be sure to keep in mind the minimum intervals between doses:
- At least four weeks between doses #1 and #2
- At least eight weeks between doses #2 and #3
- At least 16 weeks between doses #1 and #3
- If your patient falls behind on the hepatitis B vaccination schedule , continue vaccinating from where your patient left off. The series does NOT need to be restarted.
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Persons With Inadequate Immunization Records
Evidence of long term protection against HB has only been demonstrated in individuals who have been vaccinated according to a recommended immunization schedule. Independent of their anti-HBs titres, children and adults lacking adequate documentation of immunization should be considered susceptible and started on an immunization schedule appropriate for their age and risk factors. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information.
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