Accelerated Us Children And Adult 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.
In some instances, it may be necessary to vaccinate within a short period of time to ensure protection before travel. There are accelerated schedules to provide the highest level of protection over a short period of time. Individuals who need an accelerated schedule must have a booster dose at 1 year to ensure long-term protection. Note that the 2-dose Heplisav-B vaccine will also ensure maximum protection over a 1-month period without the need for a booster dose at 1 year.
4-Dose Vaccine Series for Children and Adults
Engerix-B is a 3-dose vaccine that can be given on an accelerated, four-dose schedule, with 3 shots administered within 2 months, and a booster dose at 1 year to provide maximum long-term protection.
4-Dose Combination Hepatitis A and B Vaccine Series
Twinrix is a 4-dose vaccine that can be given on an accelerated schedule to provide protection against hepatitis A and B. Three doses are administered within 1 month, followed by a booster shot at 1 year. This is a common choice of vaccine for those travelling on short-notice outside the U.S. It is important to complete the booster dose at 1 year, to ensure long-term protection.
2-Dose Vaccine Series
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Enhancing Healthcare Team Outcomes
The interprofessional health care team faces many challenges when vaccinating patients for hepatitis B. While few medical interventions have as significant an impact on health as vaccinations, and the hepatitis B vaccination is generally safe, lack of knowledge about the vaccine by healthcare team members and patient concern about adverse events can decrease coverage. Challenges on knowledge of the vaccine for healthcare team members include staying current on evolving recommendations for whom the vaccine is indicated. All team members can increase the vaccination rate of their patients by encouraging all staff to become trained in the assessment of vaccination histories and any pertinent staff in the administration of the vaccine. Protecting the time available for the team to do this is an essential component of this strategy. All patients should receive education on the benefits of vaccination, including its herd immunity effect, the generally safe side effect profile, and the relatively few contraindications. A presumption of acceptance may be effective with most patients. The hesitant parent and patient who does not respond to this can pose a challenge in vaccination. Motivational interviewing techniques have shown to be effective with these hesitant patients.
How Is Hepatitis B Treated
AcuteDoctors often recommend bed rest, drinking lots of fluids, eating a healthy diet and avoiding alcohol. Medicines are not used to treat acute hepatitis B virus. It is important to see your doctor regularly to make sure your body has fully recovered from the virus.
Chronic Hepatitis B VirusIf you have chronic hepatitis B virus, you should be monitored regularly for signs of liver disease and need for possible treatment. Not every person with chronic hepatitis B virus needs medications and the drugs may cause side effects in some people. It is however important to have regular check-ups with your doctor to observe and watch your liver disease.
There are several medications approved to treat chronic hepatitis B virus and many other medications are being developed. You should discuss these options with your doctor to find what is best for you.
hepatitis B virus medications should not be taken by pregnant women unless recommended by their doctors. Some pregnant women with hepatitis B virus should be treated to prevent transmitting hepatitis B virus to their babies. It is important to closely follow up with your doctor during pregnancy to prevent to prevent transmission of Hepatitis B to their babies.
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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.
How Is A Hepatitis B Vaccine Given
A health care provider gives the hepatitis B vaccine. The vaccine is given as a shot injected into a muscle, usually in the arm for adults and children older than 1 year and in the thigh for infants and children younger than 1 year. Vaccination with a hepatitis B vaccine is usually given as a series of injections over a period of time, depending on the specific brand of the vaccine. Read any printed information that your health care provider gives you about the hepatitis B vaccine.
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Us Infant 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.
3-Dose Vaccine Series for Infants
Since 1991, ALL medically stable infants with a birth weight of at least 2,000 g in the U.S. are recommended to receive the first dose of hepatitis B vaccine within 24 hours of birth. The additional 2 doses are given at 1 month and 6 months of age.
4-Dose Vaccine Combination Series for Infants
Combination vaccines, such as the pentavalent and hexavalent vaccines, include protection against 5 or 6 diseases, including hepatitis B. The first shot is usually given at 6 weeks of age, but in order to protect infants from hepatitis B beginning at birth, a monovalent or single dose of the hepatitis B vaccine is also recommended within 24 hours of birth. The hepatitis B vaccine series can then be completed with the pentavalent or hexavalent vaccine with the recommended schedule.
Chronic Hepatitis B Treatment Goals
When a patient has been diagnosed with chronic hepatitis B, clinical endpoints of therapy include5,17:
- Achieving sustained suppression of HBV replication
- ALT normalization
- Reducing the risk of liver damage
- HBeAg and HBsAg loss with or without seroconversion
AASLD=American Association for the Study of Liver Diseases ALT=alanine aminotransferase CDC=Centers for Disease Control and Prevention HBeAg=hepatitis B envelope antigen HBsAg=hepatitis B surface antigen HCV=hepatitis C virus USPSTF=U.S. Preventive Services Task Force.
aHepatocellular carcinoma may occur in patients with chronic HBV without cirrhosis.4
IMPORTANT SAFETY INFORMATION
BOXED WARNING: POSTTREATMENT SEVERE ACUTE EXACERBATION OF HEPATITIS B
- Discontinuation of anti-hepatitis B therapy, including VEMLIDY, may result in severe acute exacerbations of hepatitis B. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue anti-hepatitis B therapy, including VEMLIDY. If appropriate, resumption of anti-hepatitis B therapy may be warranted.
Warnings and Precautions
Adverse Reactions
Most common adverse reactions in clinical studies through week 144 were headache, upper respiratory tract infection, abdominal pain, cough, back pain, arthralgia, fatigue, nausea, diarrhea, dyspepsia, and pyrexia.
Drug Interactions
Dosage and Administration
INDICATION
IMPORTANT SAFETY INFORMATION
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Who Should Be Vaccinated Against Hepatitis B
Those who should be vaccinated against hepatitis B virus include:
- Children and adolescents not vaccinated at birth
- People with chronic liver disease not caused by hepatitis B virus
- Diabetics younger than 60 years of age
- People who have had/or are on hemodialysis, those with end-stage renal disease including those on pre-dialysis care, peritoneal dialysis, and home dialysis
- Healthcare and emergency workers, military personnel, morticians and others at risk for exposure to blood or blood-contained body fluids on the job
- Residents and staff of facilities for developmentally disabled people
- People working or house in prisons
- People with a sexually transmitted disease
- People with multiple sexual partners
- Men who have sex with men
- People with HIV
- People who have ever injected or snorted drugs
- Sexual partners and household members of people with hepatitis B virus
- Travels or those born in countries where hepatitis B virus is common
- People seeking protection from hepatitis B virus, particularly members of ethnic or racial groups with high rate of hepatitis B virus infection including Asian and Pacific Islander Americans, African Americans, Latino Americans,
- Native Americans, and Alaskan Natives
- Immigrants from countries where hepatitis B virus is common
How Can I Contract Hepatitis A
You can contract the hepatitis A virus by eating food or drinking beverages that have been contaminated by human fecal waste.
Resort activities that may put you at risk for hepatitis A include:
Eating food handled by an infected worker who did not wash his/her hands properly after using the washroom
Eating raw or undercooked seafood and shellfish that lived in sewage-polluted water
Eating salads or produce rinsed in contaminated water
Drinking contaminated water or drinks with contaminated ice
Bathing, showering, or swimming in contaminated water
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What Is The Effectiveness Of A 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.
Hepatitis A And B Vaccine Side Effects
Get emergency medical help if you have signs of an allergic reaction: hives difficult breathing swelling of your face, lips, tongue, or throat.
Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.
You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.
You may feel faint after receiving this vaccine. Some people have had seizure like reactions after receiving this vaccine. Your doctor may want you to remain under observation during the first 15 minutes after the injection.
Hepatitis A and hepatitis B vaccine may cause serious side effects. Call your doctor at once if you have:
-
numbness, pain, tingling, weakness, burning or prickly feeling, vision or hearing problems, trouble breathing
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red or blistering skin rash or
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easy bruising or bleeding .
Common side effects of hepatitis A and hepatitis B vaccine may include:
-
redness or tenderness where the shot was given
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.
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Who Should Not Receive The Hepatitis B Vaccine
Talk to your healthcare provider before getting the hepatitis B vaccine if:
- You have had a severe allergic reaction to the hepatitis B vaccine or any of its ingredients in the past.
- You have had an allergic reaction to yeast in the past.
- You are moderately or severely ill.
- You are currently taking immunosuppressive medications.
In addition, pregnant people should not receive the Heplisav-B or PreHevbrio vaccines until more safety information is available.
Common And Local Adverse Events
HB vaccine
HB vaccine is well tolerated. Reactions are generally mild and transient, and include: irritability, headache, fatigue and injection site reactions in 10% or more of recipients.
HAHB vaccine
There is no increase in adverse events when HAHB vaccine is compared with HA vaccine given alone or concomitantly with HB vaccine at a different injection site. When the adult formulation of HAHB vaccine is given to children in the 2 dose schedule, there is no increase in adverse events compared with those occurring after administration of the pediatric formulation of HAHB vaccine.
DTaP-HB-IPV-Hib vaccine
Reactions are usually mild and transient, and include fever, irritability, restlessness and injection site reactions .
HBIg
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Us Children And Adult 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.
3-Dose Vaccine Series for Children and Adults
The hepatitis B vaccine is an injection that is generally given in the arm as a three-dose series on a 0, 1, and 6-month schedule. Alternative schedules may be considered, noting that a third dose at 6 months, meeting minimum intervals between doses, is needed for maximum, long-term protection. 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.
There are four, 3-dose vaccine brands approved in the U.S.
- PreHevbrio PreHevbrio is only approved for adults age 18 and over.
2-Dose Vaccine Series
Hepatitis B Vaccine On The Nhs
A hepatitis B-containing vaccine is provided for all babies born in the UK on or after 1 August 2017. This is given as part of the 6-in-1 vaccine.
Hospitals, GP surgeries and sexual health or GUM clinics usually provide the hepatitis B vaccination free of charge for anyone at risk of infection.
GPs are not obliged to provide the hepatitis B vaccine on the NHS if you’re not thought to be at risk.
GPs may charge for the hepatitis B vaccine if you want it as a travel vaccine, or they may refer you to a travel clinic for a private vaccination. The current cost of the vaccine is around £50 a dose.
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What Are The Different Types Of Hepatitis
Hepatitis is a global concern. The World Health Organization estimates that 354 million people globally live with hepatitis B or C, the types most responsible for chronic liver disease in the form of cirrhosis, cancer and hepatitis.
The five primary strains of the virus that lead to hepatitis are labeled as types A, B, C, D and E. These strains are identified by the differences in their transmission, severity, geography and prevention.
Five types of hepatitis:
The Centers for Disease Control and Prevention reports that Hepatitis A, B and C are the most common strains in the United States. The best way to prevent hepatitis A and B is through vaccination. Chronic hep B, hep C and hep D infection can lead to long-term liver damage, cirrhosis of the liver, or liver cancer.
Difference Between Hep A And Hep B Vaccines
In the United States, the hep A shot is administered routinely to very young children. It may be given in one or two doses. If the child is getting two doses, the first one should be no later than 12 months of age. There is some flexibility in the interval between shots, but six to 18 months is common.
The hep B vaccine should be given to all babies as soon as possible after birth. After the first dose, two or three doses follow with an interval of at least four weeks. Unvaccinated adults get three doses spanning six months. If you are at least 18 years old, you have the option to get a combination vaccine. The dual vaccine is given in three shots over six months.
Adults traveling to areas with a high rate of HAV would benefit from getting the hep A shot. Talk to your physician about your risk for hep A and hep B to determine if you should receive the vaccines. You can schedule your hepatitis vaccine with your primary care physician or one of your local pharmacies, such as CVS and Walgreens.
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Who Should Get The Hepatitis B Vaccine
Most babies now get the HBV vaccine from their doctor as a regular part of their checkups.
Hepatitis B is really contagious. You can easily get it through unprotected sex or contact with infected blood or urine. So if youve never had the vaccine, its a good idea to talk to your doctor about getting it.
Important Information About Vaccine And Hepatitis B Immunoglobulin Shot Administration
Where available, the hepatitis B birth-dose and HBIG should be administered within 24 hours of birth in order to prevent the transmission of hepatitis B from mother to child. It is very important that the shots be given in opposite limbs, to ensure the highest effectiveness. Please see chart above for more information.
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How Safe Is The Hepatitis B Vaccine
The hepatitis B vaccine is totally safe for most people. Most babies, kids, and adults have no problems at all when they get the vaccine. In fact, more than 100 million people in the U.S. have gotten the hepatitis B vaccine.
Like all medicines, the hepatitis B vaccine may have some mild side effects: soreness, change in skin color, swelling, or itching around where you get the shot, or a slight fever. But these things arent serious and usually go away pretty quickly. Theres an extremely small risk of having an allergic reaction to the vaccine.
If you get dizzy, feel your heart beating really fast, have a high fever, feel weak, break out in hives, or have trouble breathing, get medical help right away. But again, the risk of having an allergy is super small.
You CANT get hepatitis from the hepatitis vaccine.
Who Is More Likely To Get Hepatitis B
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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