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.
About The Hepatitis B Vaccine Booster
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Getting the vaccine booster
Request the vaccine and complete your confidential online questionnaire. One of our clinicians will check your suitability and contact you via your Patient Record. Once approved, you can select at which LloydsPharmacy store you would like to be vaccinated and call to book your appointment.
The vaccine comes as one injection, usually given in the upper arm.
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Effectiveness
More than 9 out of 10 will be protected after receiving a booster vaccine. 4 weeks after this booster you may wish to undergo a blood test to check that you are immune.
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Side effects
Most people experience no side effects from this vaccine. However, you may experience pain, swelling or reddening of the skin at the injection site, fatigue, headache, mild fever, nausea, vomiting, decreased appetite and diarrhoea.
For How Long Is The Hepatitis B Vaccine Effective
The duration of immunity to hepatitis B virus from plasma-derived vaccine was generally believed to be around 10 years. However, rigorous determination of the upper time limit for immunity has not been carried out. Such information could be useful in devising vaccination schedules and possibly for developing public health policy with respect to the rationale for and timing of booster vaccinations.
McMahon and colleagues at the Centers for Disease Control and Prevention studied 1578 Alaska Natives vaccinated at age 6 months or older between 1981 and 1982. Subjects received three doses of plasma-derived hepatitis B vaccine appropriate for their age, and were tested annually for antibodies to hepatitis B surface antigen and HBV infection markers for the first 11 years.
Anti-HBs levels decreased in the study population from a mean concentration of 822 mIU/mL after vaccination to 27 mIU/mL at 15 years. Higher levels of anti-HBs were noted in males, individuals with higher initial anti-HB levels, and those who were older at the time of vaccination. After adjusting for initial anti-HBs level and sex, the lowest HBs levels at 15 years post-vaccination were observed in those vaccinated between 6 months and 4 years of age.
Researchers detected asymptomatic breakthrough infections in 16 participants. Infection occurred more frequently in vaccine non-responders than in responders .
Action Points
Primary Source
Annals of Internal Medicine
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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.
Facts About Hepatitis B
- Two billion people, or one in three, have been infected with hepatitis B worldwide. Of these, about 260 million live with chronic hepatitis B.
- 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 minute 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 is the fourth leading cause of cancer deaths throughout the world, behind lung, colorectal and stomach cancers.
- 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 2017, about 8 of 10 infants born throughout the world received three doses of hepatitis B vaccine.
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How Is The Hepatitis B Vaccine Given
Hepatitis B
The vaccination for hepatitis B is given as 3 injections over a 6-month period–an initial dose, followed by a second dose 1 month later, and a third dose 5 months after the second.
If you need hepatitis A vaccination in addition to hepatitis B, you can do these individually or as a combined vaccine that covers both. The combination vaccine is given as 3 injections over a 6-month period–an initial dose, followed by a second dose 1 month later, and a third dose 5 months after the second.
If you are not able to get the shots on time, it is not necessary to restart the series, but you should continue from the last dose given.
Babies born to mothers who have chronic hepatitis B should get the first shot within 12 hours after birth, followed by a second shot 1 month later, and the third shot 5 months after the second. Babies born to mothers who are not infected with the hepatitis B virus should get the first shot within 1 to 2 months after birth, the second shot a month later, and the third shot 5 months after the second.
You will NOT get hepatitis B from the vaccine.
You will be protected for about 13 years. If it has been many years since you received your hepatitis B vaccination, or if you do not know when you were vaccinated, ask your doctor to check to see if you have antibodies against hepatitis B.
Safety Of Hepatitis Vaccines
Hepatitis vaccines have been given to millions of people all across the world without any evidence of serious side effects. “They’re very safe, and they’re extremely effective,” says Poland.
If you are not sure whether you should have hepatitis vaccines, talk with your doctor about your specific concerns.
Show Sources
Recommended Reading: What Virus Causes Hepatitis A
Hepatitis B Vaccination Initiative
The purpose of the Adult Hepatitis B Vaccination Initiative is to improve the delivery of viral hepatitis prevention services in health-care settings and public health programs that serve adults at risk for viral hepatitis. The primary goals are to:
- increase the number of doses of hepatitis B-containing vaccine purchased by immunization program grantees and
- improve vaccination coverage among adults and reduce the incidence of acute hepatitis B among adults in the United States.
Twinrix® vaccine, combined hepatitis B and hepatitis A is now available at low cost to persons who qualify. The vaccine is free, but there may be an administration fee charged to give the vaccine. The maximum fee is $14.75 per dose.
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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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.
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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Treatment And Manifestation Of Hepatitis A And B
Hepatitis A has an incubation time of two to six weeks. Hepatitis B only manifests after two to six months. Often patients with hepatitis A and B infection have moderate to no signs of the infection.
In persons who show symptoms, they will get flu-like symptoms, which will occur about three to ten days before symptoms of the liver develop.
Thereafter, the urine will darken, and jaundice may grow. With jaundice, the skin and the whites of a person’s eyes have a yellow hue. The inflamed liver cannot conduct its normal biochemical processes, so a material called bilirubin increases in the body.
Typically, you tend to feel healthy when you have jaundice, even though you keep looking worse.
In hepatitis A the jaundice stage only lasts for about one week. After that, you’ll continue to heal and usually feel like your usual self within a month. You are immune for life after recovering from hepatitis A.
In hepatitis B, the jaundice stage is about two weeks.
How Hepatitis Is Spread
Hepatitis A: About 20,000 people in the U.S. contract hepatitis A each year. The hepatitis A virus is found in the stool of the infected person. It is spread through contaminated food or water or by certain types of sexual contact.
Children who get hepatitis A often don’t have symptoms, so they can have the virus and not know it. However, they can still spread it easily. Fortunately, children are now routinely vaccinated against hepatitis A.
Most people who get hepatitis A recover completely within two weeks to six months and don’t have any liver damage. In rare cases, hepatitis A can cause liver failure and even death in older adults or people with underlying liver disease.
Hepatitis B: Every year, about 40,000 people in the U.S. become infected with hepatitis B. Acute hepatitis lasts from a few weeks to several months. Many infected people are able to clear the virus and remain virus-free after the acute stage. However, for others, the virus remains in the body, and they develop chronic hepatitis B infection, which is a serious, lifelong condition. About 1.2 million people in the U.S. have chronic hepatitis B. Of these, 15% to 25% will develop more serious health problems, such as liver damage, cirrhosis, liver failure, and liver cancer, and some people die as a result of hepatitis B-related disease.
Hepatitis B cannot be spread by contaminated water, food, cooking, or eating utensils, or by breastfeeding, coughing, sneezing, or close contact such as kissing and hugging.
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I Am A Healthcare Worker Who Did Not Develop Hepatitis B Antibodies After Immunization What Should I Do
Not everyone responds to the hepatitis B vaccine. In fact, in a group of adults younger than 40 years of age who have received two doses of the vaccine only 75 of 100 will be protected. Following the third dose, this number will increase to 90 of 100. However, people older than 40 years of age will be less likely to respond to the vaccine with increasing age.
Even if people do not respond to three doses, it does not mean that they are at high risk for hepatitis B. Because hepatitis B is transmitted primarily through blood and body fluids, using safety precautions while working will help decrease the chance of exposure to the disease. It is also possible that the immune response was not great enough to be measured by the laboratory test, but would still provide some level of protection upon exposure to hepatitis B. The CDC recommends getting the three-dose series again if an immune response is not generated following the first series.
About 5-10 of every 100 children and adults younger than 40 years of age do not respond to the third dose of the hepatitis B vaccine. Some of these people will be recommended to get the series of three doses again. About 5 of 100 people will still not respond after six doses. If these people are determined not to have chronic hepatitis B, they will be reliant on taking precautions to reduce the chance of exposure and relying on those around them for protection. In other words, these people will be reliant on herd immunity.
What Are The Possible Side Effects Of Hepatitis B Immunisation
All medicines and vaccines can have side effects. Sometimes they are serious, most of the time theyre not.
Generally, the chance of having a serious side effect from a vaccine is much lower than the chance of serious harm if you caught the disease.
Talk to your doctor about possible side effects of hepatitis B vaccines, or if you or your child have possible side effects that worry you.
Common side effects of hepatitis B vaccines include:
- soreness where the needle went in
- low-grade fever
- body aches.
The Consumer Medicine Information links in How do you get immunised against hepatitis B? list the side effects of each vaccine.
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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.
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.
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Get The Shot And Stay Informed
The hepatitis A & B virus is silent but violent. The virus is 50 to 100 times more contagious than HIV and can survive outside the body for at least seven days, making it much more infectious then most infectious diseases.
Nobody is immune to the first infection, and once contracted, it can lead to chronic illness and, in extreme cases, even death.
We hope this article answered the question, “How long does Twinrix last?” Also, that it has given you further insight into hepatitis A and B.
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Who Should Get The Hepatitis B Vaccine
Most babies now get the HBV vaccine from their doctor as a regular part of their checkups.
Hepatitis B is really contagious. You can easily get it through unprotected sex or contact with infected blood or urine. So if youve never had the vaccine, its a good idea to talk to your doctor about getting it.
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What Is Hepatitis B Infection
Hepatitis B is a virus that attacks the liver. It can cause serious disease including permanent liver damage . Hepatitis B is also one of the main causes of liver cancer, which can be fatal. Hepatitis B virus is spread from one infected person to another by contact with blood or body fluids. This includes an accidental or intentional poke with a used needle, being splashed in the mouth, nose, or eyes with infected blood, being bitten by an infected person, sharing items that may have blood on them such as a toothbrush, dental floss or razor, and by having unprotected sex with someone infected with the hepatitis B virus. Mothers who are infected with hepatitis B virus can pass the virus to their newborn babies during delivery.
After the virus enters your body, it usually takes 2 to 3 months to develop symptoms or signs of illness. Symptoms of hepatitis B may include fatigue, fever, nausea and vomiting, loss of appetite, abdominal pain, dark urine, pale stools and jaundice . Many people who get hepatitis B show no symptoms and may not know they have the disease. Whether there are signs of illness or not, you can pass the virus on to others.