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Newborn Hepatitis B Vaccine Dose

What Is The Effectiveness Of A Hepatitis B Vaccine

Why Do Newborns Get the Hepatitis B Vaccine?

The hepatitis B vaccine provides over 90 per cent protection to babies, children, as well as adults who have been immunised with all three doses prior to exposure to the virus and that too long term. Besides preventing hepatitis B infection, the vaccine also averts the development of any complications like chronic disease and liver cancer.

Who Should Receive The Hepatitis B Vaccine

For most people, the hepatitis B vaccine is safe and effective. About 90% of people who receive three vaccine doses are protected against hepatitis B for over 30 years.

The CDC’s Advisory Committee on Immunization Practices recommends the hepatitis B vaccine for the following groups:

  • All babies, starting just after birth
  • Children and adolescents under 19 years old
  • Adults ages 1959 who have not previously completed vaccination
  • Adults ages 60 and over with a high risk of contracting HBV

Adults ages 60 and over who do not have any hepatitis B risk factors can receive the hepatitis B vaccine, but it is optional.

Hepatitis B spreads when the bodily fluids of an infected person enter another person’s body. Sexual contact is one way it can be spread. A person with HBV can spread it to their baby during childbirth. Other ways in which HBV may be transmitted include:

  • Sharing medical equipment, whether at home or in a hospital setting, with a person who has an HBV infection
  • Sharing syringes with a person who has hepatitis B, such as during injection drug use or at-home piercing or tattooing
  • Sharing personal items, such as razors or toothbrushes, with someone who has hepatitis B
  • Coming into contact with the sores or blood of a person who has hepatitis B

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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What Are Dosages Of Hepatitis B Vaccine

Dosages of Hepatitis B Vaccine:

Intramuscular suspension

Intramuscular suspension

Dosage Considerations Should be Given as Follows:

  • Engerix B: 1 mL intramuscularly at 0, 1, and 6 months
  • Recombivax HB: 1 mL intramuscularly at 0, 1, and 6 months
  • Adults receiving dialysis or other immunocompromising conditions
  • Recombivax HB : 40 mcg intramuscularly at 0, 1, and 6 months, OR
  • Engerix-B : 40 mcg intramuscularly at 0, 1, and 6 months

Routine vaccination

Catch-up vaccination

  • Unvaccinated children should complete a 3-dose series
  • Children aged 11-15 years: 2-dose series of adult formulation Recombivax HB is licensed for use in children aged 11 through 15 years

Dosing Considerations

Administration

Pediatric:

  • Administer in deltoid muscle for older children and adolescents anterolateral thigh preferred for neonates/infants/small children
  • Do not give intravenously/intradermal

Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System , 1-800-822-7967

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

Who Is More Likely To Get Hepatitis B

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People are more likely to get hepatitis B if they are born to a mother who has hepatitis B. The virus can spread from mother to child during birth. For this reason, people are more likely to have hepatitis B if they

  • were born in a part of the world where 2 percent or more of the population has hepatitis B infection
  • were born in the United States, didnt receive the hepatitis B vaccine as an infant, and have parents who were born in an area where 8 percent or more of the population had hepatitis B infection

People are also more likely to have hepatitis B if they

  • are infected with HIV, because hepatitis B and HIV spread in similar ways
  • have lived with or had sex with someone who has hepatitis B
  • have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
  • are men who have sex with men
  • are injection drug users
  • work in a profession, such as health care, in which they have contact with blood, needles, or body fluids at work
  • live or work in a care facility for people with developmental disabilities
  • have been on kidney dialysis
  • live or work in a prison
  • had a blood transfusion or organ transplant before the mid-1980s

In the United States, hepatitis B spreads among adults mainly through contact with infected blood through the skin, such as during injection drug use, and through sexual contact.12

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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

Your Babys First Shot

Shortly after birth, your baby should receive the first dose of the vaccine to help protect against the following disease:

All babies should get the first shot of hepatitis B vaccine within 24 hours of birth.

This shot reduces the risk of your baby getting the disease from you or family members who may not know they are infected with hepatitis B.

If you have hepatitis B, your baby should get the first shot of hepatitis vaccine within 12 hours of birth. Theres additional medicine that can help protect your newborn against hepatitis B its called hepatitis B immune globin . HBIG gives your babys body extra help to fight the virus as soon as your baby is born.

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What Is The Treatment For Hepatitis B

Prevention is recommended by receiving a vaccine for HBV.

Receiving an injection of the hepatitis B immune globulin within 12 hours of coming in contact with the virus may help prevent the development of the disease.

At present, there is no specific treatment for patients with acute hepatitis B. Acute infection is usually short and will often resolve on its own. Your health care provider may recommend rest, and adequate nutrition and fluids to help your body fight the infection. Hospitalization may be required for patients who suffer from severe vomiting and who are unable to maintain adequate nutritional levels. It may also be required to prevent the development of complications.

While chronic infection cannot be cured, there are two standard treatments in Canada that may control the virus and prevent further damage to the liver.

  • Antiviral medications can fight the virus and slow damage to the liver.
  • Interferon which may be given for short periods and if effective, results in suppression of the virus.

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Persons With Chronic Diseases

Hepatitis B Vaccine for Babies – Importance and Recommended Schedule

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.

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Infants Are Recommended To Receive 4 Doses Of Hepatitis B Vaccine

Infants are recommended to receive 4 doses of hepatitis B vaccine:

  • 1 dose of monovalent paediatric formulation hepatitis B vaccine at birth
  • 3 doses of a paediatric hepatitis Bcontaining vaccine at 2, 4 and 6 months of age .

Infants can receive the dose scheduled at 2 months of age as early as 6 weeks of age. They should still receive their next scheduled doses at 4 months and 6 months of age.

Why Is The Hepb Vaccine Recommended

People who dont know they’re infected can spread the hepatitis B virus. So it cant be avoided just by being careful. That’s why health experts recommend that all babies get the vaccine right from birth.

The HepB injection usually creates long-term immunity. Most infants who get the HepB series are protected from hepatitis B infection beyond childhood, into their adult years.

Eliminating the risk of infection also decreases risk for cirrhosis of the liver, chronic liver disease, and liver cancer.

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Indications For Recombivax Hb Indications For Recombivax Hb

RECOMBIVAX HB® is indicated for prevention of infection caused by all known subtypes of hepatitis B virus.

RECOMBIVAX HB is approved for use in individuals of all ages.

RECOMBIVAX HB Dialysis Formulation is approved for use in adult predialysis and dialysis patients 18 years of age and older.

RECOMBIVAX HB is indicated for prevention of infection caused by all known

RECOMBIVAX HB is indicated for prevention of infection caused by all known subtypes of hepatitis B virus.

RECOMBIVAX HB is approved for use in individuals of all ages.

Why Should I Vaccinate My Newborn Child If I Know That I Am Not Infected With Hepatitis B Virus

Vaccination Packages for Baby

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 didn’t 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 don’t 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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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.

Dosage Forms & Strengths

Contraindicated

  • belimumab

    belimumab decreases effects of hepatitis b vaccine by immunosuppressive effects risk of infection. Contraindicated. Do not administer live vaccines 30 days before or concurrently with belimumab.

Serious – Use Alternative

Monitor Closely

Minor

  • chloroquine decreases effects of hepatitis b vaccine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • ozanimod

    ozanimod decreases effects of hepatitis b vaccine by immunosuppressive effects risk of infection. Minor/Significance Unknown. No clinical data are available on the efficacy and safety of vaccinations in patients taking ozanimod. Vaccinations may be less effective if coadministered with ozanimod.

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Who Should Receive Hepatitis B Vaccination

  • All newborns before hospital discharge. Infants born to hepatitis B-positive women need hepatitis B vaccine and HBIG within 12 hours of birth.
  • All children and adolescents not previously vaccinated.
  • Children born in the U.S. to individuals born in a country with high hepatitis B endemicity.
  • All individuals at risk of hepatitis B infection:
  • Sex partners of hepatitis B-positive persons
  • Sexually active persons who are not in a long-term, mutually monogamous relationship
  • Persons seeking evaluation or treatment for a sexually-transmitted disease
  • Men who have sex with men
  • Persons who inject drugs
  • Household contacts of hepatitis B-positive persons
  • Persons born in countries where hepatitis B infection is endemic should be tested and vaccinated if susceptible
  • International travelers to regions with high or intermediate rates of endemic hepatitis B infection
  • Health care and public safety workers that may be exposed to blood or blood-contaminated body fluids
  • Residents and staff of facilities for developmentally disabled persons, corrections facilities, and other facilities that serve adults at risk for hepatitis B infection
  • Persons with end-stage renal disease, including pre-dialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
  • Persons with chronic liver disease
  • Persons to age 60 years with diabetes
  • Persons with HIV infection
  • All other persons seeking protection from hepatitis B infection.

What Are The Side Effects

Ending hepatitis B with crucial birth dose vaccine

The most common of the hepatitis B vaccine are mild and include:

  • Sore arm from the shot.

Prepare for your child’s vaccine visit and learn about how you can:

  • Research vaccines and ready your child before the visit
  • Comfort your child during the appointment
  • Care for your child after the shot

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What Are The Risks Of Not Getting The Vaccine

The main risk of the baby not getting the vaccine is that they may contract the hepatitis B virus.

Hepatitis B primarily attacks the liver, causing inflammation that can damage this organ over time. An acute infection lasts for less than 6 months and may cause no symptoms in some people.

Many acute infections resolve without treatment. If the infection persists for 6 months or more, doctors will refer to it as chronic. Chronic infections increase a persons risk of damage to the liver over time.

As this damage builds up, it can scar the liver, which is known as cirrhosis. This long-term damage may result in other complications, including liver cancer.

According to the WHO, about

Possible Side Effects Of Hepatitis B Vaccination

You may experience minor side effects following vaccination. Most reactions are mild and last no more than a couple of days and you will recover without any problems.

Common side effects of hepatitis B vaccines include:

  • pain, redness and swelling at injection site
  • occasionally an injection-site lump

Talk to your vaccination provider about possible side effects of hepatitis B vaccines, or if you or your child have possible side effects that worry you.

The Consumer Medicine Information available on the Therapeutic Goods Administration website lists the ingredients and side effects of each vaccine.

Learn more about the possible side effects of vaccination.

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How Is The Hepatitis B Vaccine Made

People are protected against hepatitis B virus infection by making an immune response to a protein that sits on the surface of the virus. When hepatitis B virus grows in the liver, an excess amount of this surface protein is made. The hepatitis B vaccine is made by taking the part of the virus that makes surface protein and putting it into yeast cells. The yeast cells then produce many copies of the protein that are subsequently used to make the vaccine. When the surface protein is given to children in the vaccine, their immune systems make an immune response that provides protection against infection with the hepatitis B virus.

The first hepatitis B vaccine was made in the 1980s by taking blood from people infected with hepatitis B virus and separating or purifying the surface protein from the infectious virus. Because blood was used, there was a risk of contaminating the vaccine with other viruses that might be found in blood, such as HIV. Although contamination with HIV was a theoretical risk of the early, blood-derived hepatitis B vaccine, no one ever got HIV from the hepatitis B vaccine. That is because the blood used to make vaccine was submitted to a series of chemical treatments that inactivated any possible contaminating viruses. Today, there is no risk of contaminating the vaccine with other viruses because the surface protein is manufactured in the laboratory.

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