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.
Approaches By Virus Life Cycle Stage
consist of a and sometimes a few stored in a capsule made of , and sometimes covered with a layer . Viruses cannot reproduce on their own and instead propagate by subjugating a host cell to produce copies of themselves, thus producing the next generation.
Researchers working on such “” strategies for developing antivirals have tried to attack viruses at every stage of their life cycles. Some species of mushrooms have been found to contain multiple antiviral chemicals with similar synergistic effects.Compounds isolated from fruiting bodies and filtrates of various mushrooms have broad-spectrum antiviral activities, but successful production and availability of such compounds as frontline antiviral is a long way away. Viral life cycles vary in their precise details depending on the type of virus, but they all share a general pattern:
Before cell entry
This stage of viral replication can be inhibited in two ways:
Uncoating inhibitor
Inhibitors of uncoating have also been investigated.
During Viral Synthesis
Reverse transcription
Transcription
The Hepatitis B Vaccine
The hepatitis B vaccine sometimes known by the trade name Recombivax HB is used to prevent this infection. The vaccine is provided in three doses.
The first dose can be taken on a date you choose. The second dose must be taken one month later. The third and final dose must be taken six months after the first dose.
Adolescents 11 to 15 years old may follow a two-dose regimen.
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Which Drugs Or Supplements Interact With Hepatitis B Vaccine
Patients with a weak immune system may not fully benefit from the hepatitis B vaccine.
- Some medications may decrease the effectiveness of the hepatitis B vaccine. Examples include fingolimod , belimumab , anakinra , adalimumab , infliximab, antineoplastic agents , and other immunosuppressives.
- Cancer patient’s receiving treatment with anti-cancer medications and those taking immunosuppressant medications should ask their doctor or pharmacist if the hepatitis B vaccine is right for them.
Prevalence Of Chronic Hepatitis B
The prevalence of chronic hepatitis B virus infection varies between and within countries:58-61
- < 0.5% among Caucasians in the United States, northern Europe and Australia
- 15% in Mediterranean countries, parts of eastern Europe, Africa, and Central and South America
- > 10% in many sub-Saharan African, East and Southeast Asian, and Pacific island populations
Regions where 2% of the population is positive to hepatitis B surface antigen are considered to have moderate to high prevalence. In these regions, people mainly acquire the infection perinatally or in early childhood.55
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Transporting Storing And Handling Vaccines
Transport according to National Vaccine Storage Guidelines: Strive for 5.87 Store at +2°C to +8°C. Do not freeze. Protect from light.
Infanrix hexa must be reconstituted. Add the entire contents of the syringe to the vial and shake until the pellet completely dissolves. Use reconstituted vaccine as soon as practicable. If it must be stored, hold at room temperature for no more than 8 hours.
People With Chronic Hepatitis B
The vaccine does not affect people with chronic hepatitis B virus infection there are no therapeutic benefits or associated adverse events. The vaccine is also safe in people who are already immune to hepatitis B through past natural infection, but it offers no additional benefit.
Hepatitis B is an infection caused by hepatitis B virus. It affects the liver.
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Hepatitis A Vaccine: Canadian Immunization Guide
For health professionals
Last partial chapter update
: The immunoglobulin dosage for Hepatitis A pre-exposure and post-exposure prophylaxis was increased based on the Product Monograph update for GamaSTAN®, which is available on Health Canada’s Drug Product Database.
Last complete chapter revision: March 2018
What Is Hepatitis B Vaccine
Hepatitis B vaccine gives protection against infection from the hepatitis B virus. The vaccine works by causing the body to produce antibodies against the virus responsible for hepatitis B infection and in this way protects against the disease. Hepatitis B is a virus that is easily spread through contact with the blood or bodily fluids of an infected person. For example, it can be passed on through unprotected sex, by sharing injection gear, through a needle stick injury or from mother to child during childbirth. Hepatitis B infection can cause serious problems including liver failure, cirrhosis, and liver cancer. Preventing infection can prevent these problems. Read more about hepatitis B.
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Active Vaccination To Prevent Infection
Hepatitis B vaccination is available for preexposure and postexposure prophylaxis and provides long-term protection. Hepatitis B vaccines are produced recombinantly in yeast cell systems. The vaccines contain noninfectious HBsAg , a small amount of yeast protein, and aluminum hydroxide as an adjuvant. Pediatric formulations contain trace or no thimerosal. Administration is via the intramuscular route. Adverse effects are generally mild and mainly consist of local tenderness and low-grade fever. After a vaccine series, more than 95% seroconversion is achieved, which results in > 90% efficacy. Studies are ongoing to determine length of immunity, but it is at least 20 years.
Two hepatitis B single antigen vaccines are available in the United States: Recombivax from Merck & Co. and Engerix-B from GlaxoSmithKline. Both vaccines come in doses for pediatric and adult populations. High-dose vaccines are available for adult hemodialysis and immunocompromised patients. Both vaccines are given in a three-dose series and are generally interchangeable. A fourth dose may be given if a birth dose was administered. The birth dose must be a single antigen formulation.
Booster doses of hepatitis B vaccine beyond the initial series are generally not recommended. The long incubation period of hepatitis B theoretically allows for the development of a protective anamnestic immune response after exposure.
Fabrizio Fabrizi MD, … Paul Martin MD, in, 2017
Do The Benefits Of The Hepatitis B Vaccine Outweigh Its Risks
Every year in the United States about 2,000 people die following an overwhelming hepatitis B virus infection. In addition, every year about 22,000 people are infected with hepatitis B. Some of them will remain chronically infected, putting them at high risk of the long-term consequences of hepatitis B virus infection: cirrhosis and liver cancer. In fact, with the exception of influenza virus, hepatitis B virus causes more severe disease and death in the United States than any other vaccine-preventable disease. On the other hand, the hepatitis B vaccine is an extremely rare cause of a severe allergic reaction called anaphylaxis. To date, no one has died from this reaction, but it is theoretically possible that this could occur.
Because hepatitis B virus is a common cause of severe disease and death in the United States, and because the hepatitis B vaccine does not cause permanent damage or death, the benefits of the hepatitis B vaccine clearly outweigh its risks.
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Hepatitis B Vaccine Side Effects
As with any medication, the hepatitis B vaccine may cause some side effects. Most people dont experience any unwanted effects. The most common symptom is a sore arm from the injection site.
When receiving the vaccination, youll likely receive information or a pamphlet regarding the side effects that you might expect, and others that warrant medical attention.
Mild side effects usually last only . Mild side effects of the vaccine include:
- redness, swelling, or itching at the injection site
- a purple spot or lump at the injection site
Site Of Injection For Vaccination And Antibody Response
Hepatitis B vaccination should be given in the upper arm or the anterolateral aspect of the thigh and not in the buttock. There are over 100 reports of unexpectedly low antibody seroconversion rates after hepatitis B vaccination using injection into the buttock. In one center in the USA a low antibody response was noted in 54% of healthy adult health-care personnel. Many studies have since shown that the antibody response rate is significantly higher in centers using deltoid injection than centers using the buttock. On the basis of antibody tests after vaccination, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention in the USA recommended that the arm be used as the site for hepatitis B vaccination in adults, as has the Department of Health in the UK.
These observations have important public health implications, well illustrated by the estimate that about 20% of the 60 000 people immunized against HBV in the buttock in the USA by March 1985 had failed to attain a minimum level of antibody of 10 IU/l and were therefore not protected.
Hepatitis B surface antibody titers should be measured in all people who have been immunized against HBV by injection in the buttock, and when this is not possible a complete course of three injections of vaccine should be administered into the deltoid muscle or the anterolateral aspect of the thigh, the only acceptable sites for HBV immunization.
Dean A. Blumberg, in, 2012
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Hepatitis B Vaccination In Pregnancy
Hepatitis B infection in pregnant women may result in severe disease for the mother and chronic infection for the baby.
This is why the hepatitis B vaccine is recommended for pregnant women who are in a high-risk category.
There’s no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.
And, as it’s an inactivated vaccine, the risk to the unborn baby is likely to be negligible .
Is Hepatitis B Vaccine
- There are no adequate or well-controlled trials of hepatitis B vaccine use in pregnant women. Therefore, hepatitis B vaccine should be used during pregnancyonly if the potential benefit justifies the potential risk to the fetus.
- It is not known if the hepatitis B vaccine is excreted into human milk after administration to the mother. The manufacturer recommends caution when given to nursing mothers.
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Who Should Not Get The Hepatitis B Vaccine
Generally seen as a safe vaccine, there are some circumstances in which doctors advise against receiving the HBV vaccine. You shouldnt have the hepatitis B vaccine if:
- youve had a serious allergic reaction to a previous dose of the hepatitis B vaccine
- you have a history of hypersensitivity to yeast or to any other vaccine components
- youre experiencing a moderate or severe acute illness
If youre currently experiencing an illness, you should postpone receiving the vaccine until your condition has improved.
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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Is It An Emergency
If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.
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Many People With Hbv Dont Know They Have It
HBV infections are becoming less common in the United States. But HBV is still widespread in other parts of the world. Around 257 million people living around the world currently have HBV, and many of them dont know it. Chronic HBV is often asymptomatic, and even when it isnt, it can take months for symptoms to show up.
HBV can be transmitted through sexual contact and the use of IV drugs , and other risk factors. Although rare, there
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Who Should Get The Hepatitis B Vaccine
The CDC recommends it for all babies, who should get their first dose as newborns.
Other people who need it include:
- People younger than age 19 who haven’t been vaccinated
- Anyone who has a sex partner with hepatitis B
- People who are sexually active but arenât in a long-term relationship in which both partners are monogamous
- Anyone being evaluated or treated for an STD
- Men who have sex with men
- People who share needles used to inject drugs
- Anyone who lives with someone who has hep B
- Anyone whose job routinely puts them at risk for coming in contact with blood or blood-contaminated body fluids
- People with end-stage kidney disease
- People who live and work in facilities for people who are developmentally disabled
- Travelers to regions with moderate to high rates of hepatitis B
- People with chronic liver disease
- People with HIV infections
You should not get the vaccine if you had a severe allergic reaction to an earlier dose or are allergic to yeast, because yeast is used to make the vaccine.
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.
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Reduced Risk Of Hepatocellular Carcinoma:
According to the CDC, the hepatitis B vaccine is recognized as the first anti-cancer vaccine because it can prevent primary liver cancer.3
A clear link has been demonstrated between chronic hepatitis B infection and the occurrence of hepatocellular carcinoma. In a Taiwanese study, the institution of universal childhood immunization against hepatitis B virus has been shown to decrease the incidence of hepatocellular carcinoma among children.4 In a Korean study in adult males, vaccination against hepatitis B virus has been shown to decrease the incidence of, and risk of, developing hepatocellular carcinoma in adults.5
Symptoms And Causative Agent
Hepatitis is a general term for inflammation of the liver, which may result from infectious or non-infectious causes. Viruses responsible for many cases of infectious hepatitis include hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E. Hepatitis A and B are the only hepatitis viruses for which vaccines are currently available in the United States .
The hepatitis B virus is a partly double-stranded DNA virus in the hepadnavirus family. The hepatitis A virus is a single-stranded RNA virus in the picornavirus family. Both viruses, though they are structurally unrelated to one another, infect and replicate primarily in liver cells.
The symptoms of acute hepatitis A infection are identical to those of hepatitis B infection. Early symptoms are headache, nausea, vomiting, abdominal pain, fever, rash, body aches and pains, and dark colored urine. Following this phase, jaundice , light stools, and liver pain may appear.
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