Emergency Hepatitis B Vaccination
If you’ve 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.
Vaccination For Other Groups
Specific vaccination recommendations for inmates, men who have sex with men, people who inject drugs, and sex workers
Inmates of correctional facilities should also be up to date with routinely recommended vaccines for adults, such as dT containing and MMR
Men who have sex with men should also be up to date with routinely recommended vaccines for adults, such as dT-containing and MMR
People who inject drugs should also be up to date with routinely recommended vaccines for adults, such as dT-containing and MMR
Also consider HPV vaccine .
Sex industry workers should also be up to date with routinely recommended vaccines for adults, such as dT-containing and MMR
Patient Group Directions And Off
Gardasil and Gardasil 9 are prescription only medicines and should only be administered using 1 of the following:
- prescription written manually or electronically by a registered medical practitioner or other authorised prescriber
- Patient Specific Direction
- Patient Group Direction
UKHSA have developed a national PGD template which should be reviewed and authorised locally before use. Off-label use of licensed products can be permitted under a PGD if that use is included within the PGD.
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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’ve become infected with the virus.
Transgender People And The Hpv Vaccine
Some transgender people are also eligible for the HPV vaccine.
Trans women are eligible for the HPV vaccine if their risk of getting HPV is similar to the risk of MSM who are eligible for the HPV vaccine.
Trans men are eligible if they have sex with other men and are aged 45 or under.
If trans men have previously completed a course of HPV vaccination as part of the girls’ HPV vaccine programme, no further doses are needed.
Ask the doctor or nurse at the sexual health or HIV clinic for more details.
Page last reviewed: 10 May 2019 Next review due: 10 May 2022
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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.
Individuals With A Similar Risk Profile To Msm
JCVI considers that there may be considerable benefit in offering the HPV vaccine to other individuals who have a similar risk profile to that seen in the sexual health and HIV clinic attending MSM population, including some MSM over 45 years of age, ex-workers, HIV positive women, and HIV positive men. Clinicians are able to offer vaccinations outside of the national programme using individual clinical judgement, and HPV vaccination could therefore be considered for such individuals on a case-by-case basis.
In these instances, vaccine should be purchased directly from the manufacturer and costs reclaimed. Vaccine stock centrally procured for the schools-based or the MSM programme should not be used for this purpose.
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Individuals Less Than 15 Years Of Age
HPV vaccine should be administered as a 2 dose schedule at 0 and 6 to 24 months.
Any interval between doses of between 6 and 24 months is clinically acceptable. As long as the first dose was received before the age of 15 years the 2 dose schedule can be followed. For example, if the first dose was given aged 14 years but the patient does not re-present in clinic until 17 years of age, only 1 further dose needs to be given.
Vaccination For Individuals With Bleeding Disorders
Individuals with bleeding disorders may be vaccinated intramuscularly if, in the opinion of a doctor familiar with the individuals bleeding risk, vaccines or similar small volume intramuscular injections can be administered with reasonable safety by this route. If the individual receives medication or treatment to reduce bleeding, for example treatment for haemophilia, intramuscular vaccination can be scheduled shortly after such medication or treatment is administered. Individuals on stable anticoagulation therapy, including individuals on warfarin who are up to date with their scheduled INR testing and whose latest INR was below the upper threshold of their therapeutic range, can receive intramuscular vaccination. A fine needle should be used for the vaccination, followed by firm pressure applied to the site for at least 2 minutes.
If in any doubt, consult with the clinician responsible for prescribing or monitoring the individuals anticoagulant therapy.
The individual or carer should be informed about the risk of haematoma from the injection.
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What If You Miss Your Vaccine
Anyone who misses either of their HPV vaccine doses when they became eligible in school Year 8 should speak to their school immunisation team or their GP surgery. They should make an appointment to get up to date as soon as possible.
If you have the 1st dose of the HPV vaccine at 15 years of age or over, you’ll need 3 doses to be fully protected. Having 2 doses is not as effective for older people.
Individuals 15 Years Of Age And Above
HPV vaccine should be administered as a 3 dose schedule at 0, 2 and 6 months.
In a 3 dose schedule, the second dose should be administered at least 1 month after the first dose and the third dose should be administered at least 3 months after the second dose. All 3 doses should ideally be given within 1 year, however a 24 month period is clinically acceptable.
Any eligible individual that started but did not complete the schedule before reaching the age of 25 years, should complete the vaccination course.
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Cdcs Recommended Childhood Vaccine Schedule Ensures Children Get The Best Protection During The Many Different Stages In Growth And Development
From the moment babies are born, they are exposed to numerous bacteria and viruses on a daily basis. Eating food introduces new bacteria into the body numerous bacteria live in the mouth and nose and an infant places his or her hands or other objects in his or her mouth hundreds of times every hour, exposing the immune system to still more germs. When a child has a cold, he or she is exposed to up to 10 antigens, and exposure to strep throat is about 25 to 50 antigens. Each vaccine in the childhood vaccination schedule has between 1-69 antigens. A child who receives all the recommended vaccines in the 2018 childhood immunization schedule may be exposed to up to 320 antigens through vaccination by the age of 2.
In fact, a 1994 report from the Institute of Medicine, Adverse Events Associated with Childhood Vaccinesexternal icon, states: In the face of these normal events, it seems unlikely that the number of separate antigens contained in childhood vaccines would represent an appreciable added burden on the immune system that would be immunosuppressive.
Are There Other Ways To Save On Vaccines At Walmart
If you have insurance, check to see what preventive vaccines are provided at no cost.
If you have to pay for a vaccine out of pocket, Walmarts cost-saving options include:
Walmart coupons, which could provide discounts on certain vaccines.
Walmart’s app, which provides notifications of storewide savings.
Walmarts membership program, which offers discounts on items including pharmacy offerings.
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Vaccine Efficacy In Males 1626 Years Of Age
1 clinical trial has shown the efficacy of 4vHPV vaccine in males aged 1626 years.115
Vaccination was 84100% protective against persistent anogenital infection and external genital lesions due to vaccine HPV types among HPV-naive participants.
Among HPV-naive participants in the trial, vaccine efficacy in men who have sex with men was:
- 95% against intra-anal HPV infection
- 75% against high-grade anal intraepithelial neoplasia
Efficacy of 2vHPV and 9vHPV vaccines in males has not been assessed to date. However, these vaccines have demonstrated safety and immunogenicity in adolescent and adult males.27,27,116
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’ve responded to the vaccine.
If you’ve been vaccinated by your employer’s occupational health service you can request a blood test to see if you’ve responded to the vaccine.
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Different Childhood Vaccines Can Be Given At The Same Time
Many vaccines are recommended early in life to protect young children from dangerous infectious diseases. In order to reduce the number of shots a child receives in a doctors visit, some vaccines are offered as combination vaccines. A combination vaccine is two or more different vaccines that have been combined into a single shot. Combination vaccines have been in use in the United States since the mid-1940s. Examples of combination vaccines are: DTap , trivalent IPV , MMR , DTap-Hib, and Hib-Hep B.
Often, more than one shot will be given during the same doctors visit, usually in separate limbs . For example, a baby might get DTaP in one arm or leg and IPV in another arm or leg during the same visit.
More Information On Side Effects
Reactions listed under âpossible side effectsâ or âadverse eventsâ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.
If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency through the Yellow Card Scheme
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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 Routine Vaccines Are Covered By The Affordable Care Act
If you have insurance, you may not have to pay anything for certain vaccines. Many preventive care services are provided through health insurance plans at no out-of-pocket cost to you as part of the Affordable Care Act . This means you can receive certain services without a copay or coinsurance even if you have not met your deductible. Preventive care includes wellness visits, screenings, and routine vaccines.
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Study Design Participants And Data Collection
This study entailed a secondary analysis of data from a cohort of refugees resettled in Massachusetts from 2011 through 2013. Nearly all refugees resettled in Massachusetts are screened through the Refugee Health Assessment Program of the Massachusetts Department of Public Health . RHAP is a contracted network of 12 private clinic sites and community health centers that provides health screening and immunization according to a clinical protocol established by MDPH for refugees resettled in Massachusetts. RHAP serves as initial access to primary care services, with each new refugee having 2 visits within 90 days of arrival . During an RHAP visit, refugees undergo vision, hearing, behavioral health, and dental screening have laboratory samples drawn to screen for hepatitis B, parasites, human immunodeficiency virus, anemia, vitamin D deficiency, abnormal urine chemistry, and exposure to tuberculosis receive immunizations per guidelines of the Centers for Disease Control and Prevention and are provided information about how to access health care in Massachusetts .
Individual Or Parent Requests Gardasil 9 Even Though They Have Completed A Course Of Gardasil Vaccine
The primary purpose of the national immunisation programme is to protect against HPV-related cancers. Gardasil has been shown to give good protection against HPV related cancers caused by HPV types 16 and 18. It would not be appropriate therefore as part of the NHS programme to offer Gardasil 9 to those who have had a full course of Gardasil.
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What Are The Difference Between A Hbig Vaccine And A
What are the difference between a HBIG vaccine and a Hepatitis B vaccine?
Vaccines work by stimulating a persons immune system to make antibodies . The antibodies remain in the body and will protect against the germ if a person is exposed to it in the future. The hepatitis B vaccine provides long-term protection against the hepatitis B virus however, protection is not immediate .
HBIg is hepatitis B immune globulin . It contains large amounts of hepatitis B antibodies taken from donated human blood. It is given when immediate protection against hepatitis B is needed . HBIg provides immediate protection because it contains pre-formed antibodies to hepatitis B. However, the protection is only short-term.
You can find more information about the hepatitis B vaccine here.
You can find more information about the hepatitis B immune globulin here.
– Immunization Nurse
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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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.
Eligible Individuals With A History Of Receiving An Incomplete Course Of Hpv Vaccine
Where an individual in the eligible cohort presents with an incomplete vaccination history, every effort should be made to clarify what doses they have had and when they were administered.
The course should be completed according to a vaccination schedule of 0, 2 and 6 months or 0 and 6 to 24 months, depending on the age of the individual when the first dose was administered and whether 1 or 2 doses have already been given. If the course is interrupted, it should be resumed but not repeated.
Eligible individuals who commenced a 3 dose schedule before the age of 15 years and who received the first 2 doses of vaccine at least 6 months apart do not require a third dose and should be considered to have completed the full course.
Individuals who have received 2 doses less than 6 months apart should receive a third dose as 2 doses less than 6 months apart is not considered adequate to provide long term protection.
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