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Newborn Hepatitis B Vaccine Schedule

Managing Fever After Immunisation

Hepatitis B Vaccine for Babies – Importance and Recommended Schedule

Common side effects following immunisation are usually mild and temporary . Specific treatment is not usually required.

There are a number of treatment options that can reduce the side effects of the vaccine such as giving extra fluids to drink and not overdressing if there is a fever.

Although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given check the label for the correct dose or speak with your pharmacist, especially when giving paracetamol to children.

Whats The Difference: Herbal Remedies And Supplements Vs Western Medicine

Around the world, people consider the use of herbal remedies or supplements as a natural treatment for hepatitis B and/or D infection. These natural remedies have historically been advertised to boost the immune system and improve liver health. Herbal remedies or supplements are described as products made from botanicals or plants used to treat diseases and maintain health. They can be produced in a variety of forms including liquid extracts, teas, tablets/capsules, bath salts, oils, and ointments4.

Are Hepatitis B Virus Infections Easily Avoided

Large quantities of hepatitis B virus are present in the blood of people with hepatitis B in fact, as many as one billion infectious viruses can be found in a milliliter of blood from an infected individual. Therefore, hepatitis B virus is transmitted in the blood of infected individuals during activities that could result in exposure to blood, such as intravenous drug use, tattooing, or sex with people who are infected. However, it is also possible to catch hepatitis B virus through more casual contact, such as sharing washcloths, toothbrushes or razors. In each of these cases, unseen amounts of blood can contain enough viral particles to cause infection. In addition, because many people who are infected don’t know that they are infected, it is very hard to avoid the chance of getting infected with hepatitis B virus.

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How Common Is Hepatitis B

One U.S. study following trends in hepatitis B infection over a three-year periodfound that 4.3% of the population had a past or present HBV infection.

Estimates suggest that about 240 million people around the world have chronic hepatitis B. Up to 1.89 million people in the United States have a chronic HBV infection.

Infants Born To Mothers Who Have Hepatitis B: Hepatitis B Vaccine Schedules

UK vaccination schedule: persistence of immunity to hepatitis B in ...
*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.

Protecting Your Baby

Infants born to women with hepatitis B must receive accurate doses of hepatitis B vaccine and hepatitis B immune globulin to ensure complete protection. In order to protect these infants, medications should be given immediately after birth in the delivery room or within the first 12-24 hours of life*.

* See Testing and Treatment During Pregnancy section for details. Please note that testing of all pregnant women for hepatitis B is a global recommendation.

3-Dose Vaccine Series for Infants

The World Health Organization recommends that infants born to hepatitis B positive mothers receive the first dose of the hepatitis B vaccine within 24 hours of birth, and ideally a dose of hepatitis B immunoglobulin . These shots must be followed by the additional vaccine doses given on the recommended schedule. In the U.S., infants should follow a 1 month and 6-month schedule for the additional two doses.

4-Dose Combination Vaccine Series for Infants

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A Disease Affecting Health Workers Male Homosexuals And Drug Addicts

Like many twentieth-century pharmaceutical discoveries, the development of the hepatitis B vaccine was, in part, a matter of happenstance. In 1963, research physician, Baruch Blumberg, was investigating variations in susceptibility to infections among different ethnic and racial groups when he identified a protein in the blood of Australian aborigines, which he dubbed the Australia antigen. Blumberg and colleagues initially surmised that the protein was inherited, but they soon noted a correlation between Australia antigen in the blood and hepatitis B infection, then called serum hepatitis. Gradually, the researchers came to suspect that Australia antigen, which floated freely in the blood of people infected with hepatitis B, was part of the virus that caused hepatitis. In 1967, they determined that Australia antigen was, in fact, a surface protein on the virus that caused the disease the discovery quickly led to a test to screen blood and diagnose patients. In related research, Blumberg and colleagues found that monkeys injected with highly purified Australia antigen did not progress to serum hepatitis the discovery suggested that non-infectious material could be separated from the virus itself. In 1969, the researchers patented the process for separating and purifying the antigen. The basis for the development of a vaccine, what Blumberg called the most significant outcome of their work, had thus been discovered.2

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 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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For Children And Teens Not Vaccinated Beginning At Birth

  • The dosing schedule is 0, 1 to 2 months, and 4 to 6 months.
  • There is some flexibility in this schedule. Just keep in mind the minimum intervals between doses. For hepatitis B vaccine, there must be:
  • At least four weeks between doses #1 and #2
  • At least eight weeks between doses #2 and #3
  • At least 16 weeks between doses #1 and #3

Note: A two-dose series instead of three doses may be administered to adolescents ages 11 through 15 years if using Recombivax HB® adult dose . Dose #2 is given four to six months after dose #1.

Benefits Of Hepatitis B Vaccine

HepB Immunization Schedule – Memory Palace – “Hippie Giving Birth at Home”
  • Provides a safety net to prevent perinatal infection among infants who are born to HBsAg-positive mothers who have not been identified
  • Protects infants at risk for infection after the perinatal period
  • Provides higher rates of on-time completion of the hepatitis B vaccine series for infants who get the birth dose of the vaccine
  • Reduces the risk that a child could get hepatitis B later in childhood

Most importantly, young children often have no symptoms when they develop hepatitis B infections, but they are still likely to develop problems with chronic hepatitis. In fact, 90% of children who develop hepatitis before they are 12 months old will develop chronic hepatitis B.

What’s more, there is no cure for chronic hepatitis B and there are very few reliable treatments. For this reason, vaccinating babies against the infection has become a routine part of a newborn’s hospital care, just like checking their hearing or listening to their heart.

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Concerns About Immunisation Side Effects

If the side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your child’s condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital.

It is important to seek medical advice if you are unwell, as this may be due to other illness, rather than because of the vaccination.

Immunisation side effects may be reported to SAEFVIC, the Victorian vaccine safety and reporting service. Discuss with your immunisation provider how to report adverse events in other states or territories.

Hepatitis B Vaccine: Canadian Immunization Guide

For health professionals

Last partial content update : May 2022

The footnotes in and the accompanying text description for the figure have been revised to align with the corresponding figure in Protocole d’immunisation du Québec, 5e édition from which it was adapted.

Last complete chapter revision :

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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.

Guidance On Reporting Adverse Events Following Immunization

Immunisation: inject to protect

Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.

Refer to Reporting Adverse Events Following Immunization in Canada and Adverse events following immunization in Part 2 for additional information about AEFI reporting.

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Strides In Western Health Care

The long-standing hesitancy to participate in western health care is well-reasoned and firmly rooted in past wrongdoing on the part of often fundamentally racist institutions. While the western health care system remains far from perfect, it is important to remember that many strides continue to be made to correct the misdeeds of the past, and conversations around health equity and the social determinants of health are becoming more and more common. Meanwhile, research has found that beliefs and misconceptions around western medicine can delay care and increase morbidity rates of hepatitis B in high-risk communities2.

To learn more about effective hepatitis B and D medications, check out our Drug Watch page!

Disclaimer: Herbal products are not U.S. FDA-approved, and the Hepatitis B Foundation cannot endorse the usage of such products that lack regulation and scientific evidence to deem them both effective and safe.

References

  • El-Serag, H., McGlynn, K. A., Graham, G. N., So, S., Howell, C. D., Fang, T., & Thiel, T. K. . Achieving health equity to eliminate racial, ethnic, and socioeconomic disparities in HBV-and HCV-associated liver disease.The Journal of Family Practice,59, S37.
  • Mukhtar, N. A., Evon, D. M., Yim, C., Lok, A. S., Lisha, N., Lisker-Melman, M., & Khalili, M. . Patient knowledge, beliefs and barriers to hepatitis B Care: results of a multicenter, multiethnic patient survey.Digestive diseases and sciences,66, 434-441.
  • How Hepatitis B Spreads

    Because hepatitis B is transmitted from person to person through blood and other body fluids, it is a sexually transmitted infection , but people can get the virus from casual contact with others as well, like sharing a razor or using the wrong toothbrush. Even a bite from an infected child can spread the infection.

    Newborns are at high risk of getting hepatitis B through childbirth from mothers who are already infected with the virus. What’s more, they can get the virus regardless of whether they are born vaginally or through a c-section. Unfortunately, even children born to a mother who doesn’t have hepatitis B are at risk because the infection spreads so easily from person to person.

    It’s impossible to tell if someone has hepatitis B just by looking at them. In fact, most people with hepatitis B have no symptoms, don’t feel sick, and are unaware that they even have the illness. Consequently, they can spread the virus to other people without even knowing it.

    The only way to know if someone has hepatitis B is through a blood test. And once people find out that they have it, it’s often in the advanced stages. Even if it is caught early, there is very little that can be done medically for people with the disease. In fact, the younger a person is when they become infected, the more likely they are to have lifelong liver problems.

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    How The Hepatitis B Virus Works

    In the case of the hepatitis B virus, the host is the liver cell. As the virus makes more copies of itself, the liver may become damaged, and sometimes it is unable to carry out its essential tasks to regulate metabolism, nutrients, and digestion. It is best to prevent hepatitis B infections when we can and since antibodies are the best defense against the virus, the hepatitis B vaccine can be used to signals the body to make antibodies to fight the virus. The hepatitis B vaccine provides lifelong protection from the virus. However, this is only possible before infection with the virus. If somebody is already infected with the virus, antiviral therapy is used to control the virus and prevent liver damage antiviral medications disrupt the life cycle of the virus by disabling viral receptors from binding to liver cells.

    Moving To Another Country

    Pediatrics Hepatitis B A Vaccination Vaccine Jaundice Immunization Schedule Dose

    If you are moving abroad before your baby is one year old, please let your GP know and dont forget to register your baby with a new family doctor in your new country of residence.

    Take your babys Red Book with you and make sure your baby receives all of the doses of hepatitis B vaccines on time and has a blood test at 12 months old.

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    Immunisation Against Hepatitis B For People At Risk

    In Victoria free hepatitis B vaccine is provided for people who are at increased risk, including:

    • Men who have sex with men.
    • People living with HIV.
    • People living with hepatitis C.
    • People no longer in a custodial setting who commenced, but did not complete, a free vaccine course while in custody.
    • Aboriginal and Torres Strait Islander people.
    • People born in priority hepatitis B endemic countries who arrived in Australia in the last 10 years priority countries include China, Philippines, Malaysia, Vietnam, Afghanistan, Thailand, South Korea, Myanmar , Indonesia, Singapore, Hong Kong, Taiwan and Cambodia.
    • Vulnerable citizens people who have experienced hardship that prevented them from accessing the vaccine earlier. Vulnerable citizens are vaccinated based on an individual assessment by an immunisation provider.

    Immunisation is also recommended, but not free, for people who are at increased risk including:

    If you think you have been exposed to hepatitis B, see a doctor immediately. Your doctor can give you treatment that, in some instances, can greatly reduce your risk of infection with hepatitis B.

    Remember that being immunised against hepatitis B does not protect you against HIV, hepatitis C or other diseases spread by blood or bodily fluids. It is important that you take precautions to make sure you are not exposed to these diseases.

    What Puts One At Risk For Reactivation

  • Virologic factors such as high baseline HBV DNA, hepatitis B envelope antigen positivity , and chronic hepatitis B infection that persists for more than 6 months.
  • Detectable HBV DNA levels and detectable levels of HBsAG can increase the risk for HBRr
  • Testing positive for HBeAg also increases the risk for reactivation
  • Co-infection with other viruses such ashepatitis C or hepatitis Delta
  • An underlying condition requiring immunosuppressive therapies
  • Certain medications can increase the likelihood of reactivation by more than 10%.
  • B-cell depleting agents such as rituximab, ofatumumab, doxorubicin, epirubicin, moderate or high-dose corticosteroid therapy lasting more than 4 weeks.
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    International 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.

    The hepatitis B vaccine is an injection that is generally given in the arm and as a three-dose series. The World Health Organization recommends a 0, 1, and 6-month vaccine schedule, though schedules may vary based on a countrys national immunization program. Completing the hepatitis B vaccine series, preferably beginning at birth, will ensure protection against hepatitis B, hepatitis delta and lower the lifetime risk of liver cancer. Greater than 90% of babies and up to 50% of young children who are not vaccinated and are infected with hepatitis B will have lifelong infection, which makes the birth dose essential to their protection. Please note that the vaccine brand name, manufacturer and associated schedules for adults, children and infants may be unique to different countries, though there is a list of WHO prequalified vaccines.

    3-Dose Vaccine Series for Infants

    The World Health Organization recommends all infants receive the first dose of the hepatitis B vaccine within 24 hours of birth and to complete the vaccine series with additional shots at 1 month and 6 months of age. Beginning the hepatitis B vaccine at birth will ensure protection against hepatitis B for life.

    3-Dose Vaccine Series for Children and Adults

    4-Dose Combination Vaccine Series for Infants

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