Subunit Recombinant Polysaccharide And Conjugate Vaccines
Subunit, recombinant, polysaccharide, and conjugate vaccines use specific pieces of the germlike its protein, sugar, or capsid .
Because these vaccines use only specific pieces of the germ, they give a very strong immune response thats targeted to key parts of the germ. They can also be used on almost everyone who needs them, including people with weakened immune systems and long-term health problems.
One limitation of these vaccines is that you may need booster shots to get ongoing protection against diseases.
These vaccines are used to protect against:
Important: How To Use This Information
This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Combination Vaccines And Fda Licensure
Only combination vaccines licensed by FDA should be used . Vaccination providers should not combine separate vaccines into the same syringe to administer together unless mixing is indicated for the patients age and is explicitly specified on the FDA-approved product label inserts. Only 2 combination vaccines, contain separate antigen components for which FDA approves mixing by the user. The safety, immunogenicity, and effectiveness of unlicensed combinations are unknown.
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A Look At Each Vaccine: Hepatitis A Vaccine
The hepatitis A vaccine is recommended for all children between 12 months and 18 years of age living in the United States. It is also recommended for others who are considered to be at increased risk of infection, including:
- Those traveling to countries with moderate or high rates of hepatitis A
- Those in close contact with a child adopted from a country with moderate or high rates of hepatitis A
- People experiencing homelessness
- Men who have sex with men
- People who use injection or non-injection drugs
- People with chronic liver disease or HIV infection
- People with increased risk of exposure because of their job
- Pregnant women who might be at increased risk
- Unvaccinated people 1 year of age and older who are at risk for hepatitis A during outbreaks
- People who have been exposed to hepatitis A in the last two weeks .
The hepatitis A vaccine is typically given as a series of two shots the second administered at least 6 months after the first. Children receiving the first shot should be at least 1 year old. Those up to 18 years old who have not been vaccinated against hepatitis A should get the vaccine.
Because hepatitis A outbreaks occur each year in the U.S., adults who wish to be protected against the disease can be vaccinated.
How And When Do Doctors Give Vaccines
For the hepatitis A vaccine:
You should get two doses, given as shots, 6 months apart for complete protection. The virus in the vaccine is killed .
Children should get the first dose between 12 and 23 months of age. Children older than age 2 can get the first dose at their next doctorâs visit.
If you need the vaccine because of upcoming travel, get it at least 1 month before you go.
For the hepatitis B vaccine:
For long-lasting immunity, you need three to four doses, depending on which type of vaccine is used. You get them as shots.
Children should get their first dose at birth and complete the series by age 6 months. Usually, the baby would get a second dose at 1 month old and the third dose at 6 months.
Babies born to women who have hepatitis B need a shot of hep B antibodies, as well as their first hep B vaccine shot, when theyâre born. They will also need follow-up blood tests to make sure theyâre OK.
Catch-up vaccinations are recommended for children and teens who were never vaccinated or who did not get all three shots.
If you’re an adult who wants to be vaccinated, you should talk about it with your doctor or pharmacist. If you are considering both vaccines, ask your doctor about vaccines that combine hep A and B.
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Extra Doses Of Vaccine Antigens
Administering extra antigens contained in a combination vaccine should be avoided in most situations . Using combination vaccines containing certain antigens not indicated at the time of administration to a patient might be justified when 1) the extra antigen is not contraindicated, 2) products that contain only the needed antigens are not readily available, and 3) potential benefits to the patient outweigh the potential risk for adverse events associated with the extra antigens. An extra dose of many live-virus vaccines and Hib or hepatitis B vaccine has not been found to be harmful . However, the risk for an adverse event might increase when extra doses are administered at an earlier time than the recommended interval for certain vaccines .
A vaccination provider might not have vaccines available that contain only the antigens needed as indicated by a childs vaccination history. Alternatively, although the indicated vaccines might be available, the provider might prefer to use a combination vaccine to reduce the required number of injections. In such cases, the benefits and risks of administering the combination vaccine with an unneeded antigen should be carefully considered and discussed with the patient or parent.
Enhancing Healthcare Team Outcomes
Vaccination providers, including the pharmacist and nurse practitioner, commonly encounter persons who do not have adequate immunization documentation. Only written, dated records should be used as evidence of vaccination. If records are not available, these patients should receive their age-appropriate vaccination schedule or have serologic testing to determine immunity. However, not all commercially available serologic tests are sensitive enough for the detection of vaccine-induced immunity.
Vaccination administration should be as close to the recommended intervals as possible. An interruption in the vaccination schedule does not require restarting the entire hepatitis A vaccine series or the addition of extra doses.
Only severe allergy to a prior HAV is a valid contraindication to vaccination. Misperceptions by healthcare providers result in missed opportunities to administer recommended vaccinations and should be avoided. Routine physical examinations are not necessary for vaccinating persons who appear to be healthy.
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Confirmation Of Expression Of Two Different Types Of Vp1 In Cefs Infected With Rc
Expression of two different types of VP1 protein in rC-KCE-2VP1 was evaluated by immunofluorescence and Western blot. For IFA, the CEFs grown on coverslips in six-well plates were infected at an MOI of 1 with rC-KCE-2VP1 or C-KCE. Monoclonal antibodies against VP1/DHAV-1 and VP1/DHAV-3 were used as primary antibodies. Details of the methods used for produce mAb against VP1/DHAV-1 and VP1/DHAV-3 are provided elsewhere . Briefly, adult female BALB/c mice were injected with purified VP1/DHAV-1 or VP1/DHAV-3 protein with adjuvant. The secondary antibodies were fluorescein isothiocyanate-labeled goat anti-rabbit IgGs . The CEFs nuclei were then stained with 4-6-diamidino-2-phenylindole . The cells were observed under a fluorescence microscope . For Western blot analysis, VP1 expression was analyzed in CEFs in six-well plates infected with rC-KCE-2VP1 and C-KCE at an MOI of 1. mAb against VP1/DHAV-1 and VP1/DHAV-3, mAb against 2VP1, Polyclonal antibodies against gB , and mAb against GAPDH for the control were used as primary antibodies. Goat horseradish peroxidase -conjugated anti-rabbit or anti-mouse IgGs were used as secondary antibodies. The bands were visualized using ECL detection reagents in accordance with the manufacturers instructions.
What Causes Hepatitis A
The hepatitis A virus causes this type of hepatitis and spreads through contact with an infected persons stool. Contact can occur by
- eating food made by an infected person who did not wash his or her hands after using the bathroom
- drinking untreated water or eating food washed in untreated water
- placing a finger or an object in your mouth that came into contact with an infected persons stool
- having close personal contact with an infected person, such as through sex or caring for someone who is ill
You cannot get hepatitis A from
- being coughed on or sneezed on by an infected person
- sitting next to an infected person
- hugging an infected person
A baby cannot get hepatitis A from breast milk.4
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How Do Doctors Treat Hepatitis A
Treatment includes resting, drinking plenty of liquids, and eating healthy foods to help relieve symptoms. Your doctor may also suggest medicines to help relieve symptoms.
Talk with your doctor before taking any prescription or over-the-counter medicines, vitamins or other dietary supplements, or complementary or alternative medicinesany of these could damage your liver. You should avoid alcohol until your doctor tells you that you have completely recovered from hepatitis A.
See your doctor regularly to make sure your body has fully recovered. If you have symptoms for longer than 6 months, see your doctor again.
Detection Of Viral Load After Dhav
To determine the effect of rC-KCE-2VP1 on viral replication, viral load in the liver, spleen, heart, kidney, and brain of ducks in each group were examined by the one-step real-time TaqMan RT-PCR assay. The challenge in the DHAV-1 virus was not recovered in any organs tested in the rC-KCE-2VP1 vaccinated ducks at weeks 1, 2, and 4 pv, and only low titers of challenge DHAV-1 virus were detected at day 3 pv, with average viral loads ranging from 102.68 copies/g to 103.61 copies/g . On the contrary, in the PBS- and C-KCE-inoculated groups, DHAV-1 replication was detected in the livers at all four time points pv with high average viral loads ranging from 1011.23 copies/g to 109.49 copies/g. Correspondingly, the mean viral loads ranged from 109.96 copies/g to 108.94 copies/g, 108.67 copies/g to 107.58 copies/g, 108.78 copies/g to 106.98 copies/g, and 108.15 copies/g to 106.81 copies/g in the spleens, hearts, kidneys, and brains, respectively . The viral loads of DHAV-1 in the liver and spleen were significantly higher than those in other organs, which is consistent with previous research . Similar results were observed in the DHAV-3 challenge group . Together, our data indicated that vaccination with rC-KCE-2VP1 completely blocked DHAV-1 and DHAV-3 replication in ducks as early as 1 week pv.
TABLE 1.Replication of challenge virus in ducks.
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The Threat Of Hepatitis A Virus
Although the threat of hepatitis A virus infection is high in developing countries, the United States is not, by any means, hepatitis A virus-free. Each year, about 1,000-17,500 people in the United States, many of whom are children, contract hepatitis A virus. And every year about 75 people die from hepatitis A virus infection. As a result, the Centers for Disease Control and Prevention recommends that all children get the hepatitis A vaccine between 12 and 23 months of age. Those up to 18 years of age who have not previously received hepatitis A vaccine should also be vaccinated.
How Did You Discover That You Were Infected With Hepatitis B
I think I was tested because my mother was having liver issues, and my family comes from a high prevalence country, namely Vietnam, where chronic hepatitis B affects around 20% of the population. In countries with such high levels, people usually get it during birth or through little childhood scratches if they’re not vaccinated. Probably, my mother gave it to me when I was a baby.
Dr Thomas Tu
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How Else Does That Stigma Manifest Itself
It also quite closely connected to racism: at least in Australia. The majority of people with chronic hep B were born overseas theyre mostly migrants. My parents came to Australia as part of the first major migrations after the White Australia policy had been lifted. This was a policy in place for 70 years to stop all non-European migration to Australia, and part of the justification was that the Chinese were bringing in these diseases like smallpox or typhoid.
I was raised with this culture of: just put your head down and try to fit in. Dont raise anything that will make you look like you’re different. That inhibits a lot of those discussions with anyone about hep B.
Hepatitis A In Other Countries
Hepatitis A occurs worldwide. Developing countries with poor hygiene measures are at higher risk of hepatitis A infection and transmission.
In areas of high endemicity, such as parts of Africa, Asia, Central America and South America, up to 90% of children have been infected with hepatitis A.2
Hepatitis A is commonly reported in foodborne outbreaks.
Inactivated hepatitis A vaccines are prepared from hepatitis A virus harvested from human diploid cell cultures.
Different strains of HAV are in different vaccines, but there is only 1 known serotype. Immunity induced by a particular strain probably protects against all strains. 7
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Reducing The Risk Of Hepatitis A
Protecting yourself from hepatitis A
The most important action you can take to protect yourself against hepatitis A is to get vaccinated.
Practising strict personal hygiene is also essential to reducing the risk of hepatitis A. Steps you can take include:
- Wash your hands with soap and hot running water before handling food, after going to the toilet and after handling used condoms or having contact with nappies or the anal area of another person. Use a clean towel to dry your hands.
- Use barrier protection when engaging in oral-anal sex and avoid sex with someone who is infected with the hepatitis A virus.
- Vaccination may prevent illness if given within 2 weeks of contact with an infectious person.
- Clean bathrooms and toilets often, paying attention to toilet seats, handles, taps and nappy change tables.
- Boil your drinking water if it comes from an untreated source, such as a river.
- If you are travelling overseas, particularly to countries where hepatitis A is widespread, take special care to avoid hepatitis A. Before travelling, talk to your doctor about immunisation for protection.
Protecting others from hepatitis A
If you have hepatitis:
- Wash eating utensils in soapy water, and machine wash linen and towels.
Household contacts and sexual partners of an infectious person may need to be immunised.
All people who have hepatitis A should check with their doctor before returning to work or school.
Protecting yourself from hepatitis A when overseas
Spacing Of Multiple Doses Of The Same Antigen
Vaccination providers should adhere to recommended vaccination schedules . Administration at recommended ages and in accordance with recommended intervals between doses of multidose antigens provides optimal protection.
Administration of doses of a multidose vaccine using intervals that are shorter than recommended might be necessary in certain circumstances, such as impending international travel or when a person is behind schedule on vaccinations but needs rapid protection. In these situations, an accelerated schedule can be implemented using intervals between doses that are shorter than intervals recommended for routine vaccination . The accelerated or minimum intervals and ages for scheduling catch-up vaccinations. Vaccine doses should not be administered at intervals less than these minimum intervals or at an age that is younger than the minimum age.*
Certain vaccines produce increased rates of local or systemic reactions in certain recipients when administered more frequently than recommended . Careful record keeping, maintenance of patient histories, use of immunization information systems , and adherence to recommended schedules can decrease the incidence of such reactions without adversely affecting immunity.
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Live Attenuated Hepatitis A Vaccine
Extract from report of GACVS meeting of 16-17 June 2010, published in the WHO Weekly Epidemiological Record on 23 July 2010
Live attenuated hepatitis A virus vaccines have been developed, manufactured and licensed in China. Since 2007, hepatitis A vaccines have been integrated into the national immunization programme. Managers of regional immunization programmes may opt to use any of the vaccines. More than 10 million doses of H2 and L-A-1 vaccine are used annually in China. The only other country where the live vaccine is registered is India, where the H2-strain vaccine was licensed in 2005 and is used only on the private market.
An overview of the development and manufacture of hepatitis A vaccines in China was presented to the Committee. The live attenuated H2-strain and L-A-1-strain vaccines were developed from strains isolated from 2 children with hepatitis they were attenuated with multiple cell-culture passages. Vaccine lots are made in locally developed human diploid embryonic lung fibroblast cells . A special additive is used to stabilize virus titre on lyophilization.
What Are The Side Effects Of The Hepatitis A Vaccine
The hepatitis A vaccine is made from inactive virus and is quite safe. In general, there are very few side effects. The most common potential side effect is soreness at or around the injection site. Other potential side effects include mild headache, loss of appetite among children, and feeling tired. These side effects usually last 1 or 2 days. However, like any medicine, the vaccine could cause serious problems, such as an allergic reaction, which may appear within a few minutes or hours after getting the shot. This occurs very rarely, but if you believe you are having a reaction to the vaccine you should call your provider right away. Some warning signs of a serious allergic reaction include the following:
- High fever
- Weakness or dizziness
- A fast heart beat
You will NOT get hepatitis A from the vaccine, and receiving the vaccine is much safer than getting the disease itself.
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Hepatitis A Immunisation Is Recommended For High
In Victoria, the vaccine is recommended for:
- people travelling to places where hepatitis A is common
- people whose work puts them at increased risk of infection including:
- plumbers and sewage workers
- people who work with children
- people who work with people with developmental disabilities
Remember that immunisation against hepatitis A does not protect you against hepatitis B or hepatitis C.