Infants Born To Hbsag
The routine schedule for these infants is a birth dose of monovalent HepB plus HBIG, then three routine doses of DTaP-IPV-HepB/Hib at ages 6 weeks, 3 months and 5 months.
All pregnant women should receive antenatal screening for hepatitis B infection by testing for HBsAg. Infants of HBsAg-positive mothers are to be notified at birth using the form HE1446: Consent for hepatitis B vaccine and hepatitis B immunoglobulin and notification to the Medical Officer of Health, available from the Health Ed website or the local authorised health education resource provider or public health unit.
Infants born to HBsAg-positive mothers should receive:
- 100110 IU HBIG neonatal, at or as close as possible to birth
- a birth dose of HepB which should be given at or as close as possible to birth .
If HBIG and/or HepB is inadvertently omitted, administer as soon as the omission is recognised. HBIG can be administered up to seven days post-delivery. If there is a delay for longer than seven days, seek specialist advice.
These infants should then continue as per the Schedule at ages 6 weeks, 3 months and 5 months. Serological testing is required at 9 months of age .
The vitamin K injection may also be given at the same time, in the same limb as the HBIG, but not at the same site.
Infants born to mothers who received oral antiviral therapy for chronic HBV must still receive the recommended neonatal HBIG/vaccine schedule. All other vaccines are administered as per the Schedule.
Babies And Hepatitis B Vaccination
Pregnant women have a routine blood test for hepatitis B as part of their antenatal care.
Babies born to mothers infected with hepatitis B need to be given a dose of the hepatitis B vaccine within 24 hours of their birth, followed by further doses at 4, 8, 12 and 16 weeks of age, plus a final dose when they’re 1 year old.
Babies of mothers identified by the blood test as particularly infectious might also be given an injection of HBIG at birth on top of the hepatitis B vaccination to give them rapid protection against infection.
All babies born to mothers infected with hepatitis B should be tested at 1 year of age to check if they have become infected with the virus.
Who Should Get The Hepatitis A Vaccine
The CDC recommends that all children between ages 12 months and 23 months get this vaccine as well as for any infant aged 6 to 11 months who is traveling internationally.
The following people are also at risk for the disease and should be vaccinated:
- Children and teens through age 18 who live in states or communities that have made this vaccination routine because of a high rate of disease
- Men who have sex with men
- Anyone who uses illegal drugs
- People with chronic liver disease
- Anyone treated with blood clotting drugs, such as people with hemophilia
- People who work with HAV-infected primates or in HAV research laboratories.
- Travelers to countries where hepatitis A is common. A good source to check is the CDCâs travelersâ health website, which you can search by the country youâre going to.
- People adopting or close to a child adopted from a country where hepatitis A is common
You should not get the vaccine if you’re allergic to any ingredients in it or if you had a severe allergic reaction to an earlier dose of it. Tell your doctor or pharmacist about any allergies you have.
If you’re pregnant, let your doctor know. The safety of this vaccine for pregnant women is unknown, although the risk is considered to be very low.
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Is It Safe To Give My Newborn Baby The Birth Dose Of Hepatitis B Vaccine
Yes, the hepatitis B vaccine is safe to be given to a newborn.
The hepatitis B vaccine is not a live vaccine and provides protection without causing disease. It is produced in yeast cells and is free of animal or human blood products. It does not interfere with breastfeeding.
Extensive experience shows that the birth dose of hepatitis B vaccine is very well tolerated by newborn babies.
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:
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Vaccine Side Effects & Injury Lawyers
If you or a loved one has been the victim of a vaccine side effect, you should contact a vaccine lawyer with experience in this type of complex litigation.
We have recently partnered with Schmidt & Clark, LLP a Nationally recognized law firm who handles vaccine lawsuits in all 50 states.
The lawyers at the firm offer a Free Confidential Case Evaluation and may be able to obtain financial compensation for you or a loved one by filing a vaccine lawsuit or claim with The National Vaccine Injury Compensation Program. Contact Schmidt & Clark today by using the form below or by calling them directly at .
Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. In many countries outside of Canada, HB vaccine is in limited use.
All persons from a country that is endemic for HB should be assessed and vaccinated against HB if not immune and not infected. Individuals born in developing countries are more likely to be carriers of HB, necessitating vaccination of their sexual and household contacts based on review of their serologic test results. HB vaccine is recommended for all household contacts whose families have immigrated to Canada from areas in which there is a high prevalence of HB and who may be exposed to HB carriers through their extended families or when visiting their country of origin.
Children adopted from countries in which there is a high prevalence of HB infection should be screened for HBsAg and, if positive, household or close contacts in the adopting family should be immunized before adoption or as soon as possible thereafter. Adults going to pick-up children from these countries should be vaccinated before departure. Refer to Immunization of Persons New to Canada in Part 3 for additional information.
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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?
Who Is Allowed To Have The Vaccine
The vaccination is routinely available to children as part of the NHS 6-in-1 vaccine schedule from birth at 8, 12 and 16 weeks of age.
Although the risk of infection is low in the UK, the virus persists for longer in children than it does adults so to avoid complications such as scarring and even liver cancer theyve given the vaccine.
Other high risk groups of people offered the vaccine include:
close family or sexual partners of someone with hepatitis B male and female sex workers people with any form of chronic liver disease people who inject drugs or have a partner who injects drugs babies born to infected mothers people who change their sexual partners frequently men who have sex with men anyone who receives regular blood transfusions or blood products, and their carers people with chronic kidney disease people who work somewhere that places them at risk of contact with blood or body fluids, such as nurses, prison staff, doctors, dentists and laboratory staff people travelling to high-risk countries prisoners families adopting or fostering children from high-risk countries
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Dose And Administration Of Hepatitis B Vaccine
The dose for Engerix-B and Recombivax HB is 0.5 mL IM up to age 20 years or 1 mL IM for adults . The dose for HepB-CpG 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 first and second doses are separated by 4 weeks, and the third dose is given 4 to 6 months after the second dose. However, a 2-dose schedule using Recombivax HB can be used the second dose is given 4 to 6 months after the first.
Adults age 19 through 59 years who have not been previously vaccinated should complete a 2- or 3-, or 4-dose series. The usual schedule for adults using Engerix-B or Recombivax HB is a 3-dose series with 2 doses separated by 4 weeks, and a third dose 4 to 6 months after the second dose. HepB-CpG 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.
HepB-CpG 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 2 doses of Engerix-B 20 mcg/mL given simultaneously in a 4-dose schedule at 0, 1, 2, and 6 months.
Recommended Doses Of Hepatitis B Vaccine
Recommended doses of hepatitis B by vaccine type, age, formulation, dosage and schedule.
Download PDF version formatted for print: Recommended Doses of Hepatitis B Vaccine
Infants: birth, 1-4, 6-18 monthsOROlder children: 0, 1-2, 4-6 months
20 years & older
Infants: birth, 1-4, 6-18 monthsOROlder children: 0, 1-2, 4-6 months
0, 1, 4-6 months
* The schedule for hepatitis B is flexible, but minimal intervals and minimum ages need to be observed:
- There should be at least 4 weeks between doses 1 and 2, and at least 8 weeks between doses 2 and 3.
- The minimum interval for the overall series from dose 1 to final dose is 4 months .
- Infants, should receive the final dose of hepatitis B vaccine on or after 6 months of age, otherwise long term immunity may be impacted.
- Adults who are immunocompromised or on dialysis require a larger dose of hepatitis B vaccine.
- The Engerix-B dose required is 40mcg/2.0mL on a scheduled of 0, 1, 2, and 6 months.
- For Recombivax HB, a special formulation is available. The dose is 40mcg/1.0mL given on a schedule of 0, 1, and 6 months
6 weeks thru 6 years
Hep B as Engerix-B 10 mcg, DTaP as Infanrix, Polio
Give single antigen hep B dose at birth followed by Pediarix at: 2, 4, 6 months
Hep A as Havrix 720 El.U, Hep B as Engerix-B 20 mcg
0, day 7, day 21-30, 12 months
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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.
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 didnt 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 dont 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.
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What Are Hepatitis B Vaccine Names
There are two single-antigen vaccines and three combination vaccines against Hepatitis B. The names of the single vaccines are:
- Engerix-B® vaccine made by GlaxoSmithKline. It is a recombinant viral / IM vaccine that was approved in 1989.
- Recombivax HB® vaccine made by Merck. It is a recombinant viral / IM vaccine that was approved in 1986.
The names of the combination vaccines against Hepatitis B are:
- Pediarix®: Combined hepatitis B, diphtheria, tetanus, acellular pertussis , and inactivated poliovirus vaccine. Cannot be administered before age 6 weeks or after age 7 years.
- Twinrix®: Combined Hepatitis A and hepatitis B vaccine. Recommended for persons under 18 years old who are at increased risk for both Hepatitis A virus and HBV infections.
- Comvax® : Combined Hepatitis B-Haemophilus influenzae type-b conjugate vaccine. Cannot be administered before age 6 weeks or after age 71 months.
I Am A Healthcare Worker Who Did Not Develop Hepatitis B Antibodies After Immunization What Should I Do
Two versions of hepatitis B vaccine are available. One, called Heplisav-B, contains a novel adjuvant that was not present in previous versions used by adults . Some people did not respond to the older version hepatitis B vaccine. In fact, in a group of adults younger than 40 years of age who received two doses of the older version vaccine 75 of 100 were protected. Following the third dose, this number increased to 90 of 100. However, people older than 40 years of age were less likely to respond to the vaccine with increasing age. On the other hand, 90 to 100 of 100 adults 18 years of age and older respond to Heplisav-B, which was approved for use in 2018.
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 vaccinated again. About 5 of 100 people will still not respond after getting all recommended doses of both series. Note that children younger than 18 years of age cannot get Heplisav-B.
If the people who do not respond to vaccination 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.
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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: