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.
How Do Doctors Test For Hepatitis B Immunity
Doctors may order a panel of blood tests to check if someone has HBV:
- Hepatitis B surface antigen : This test looks for the presence of HBV in the blood by looking for antigens found on the virus. A positive result means that a person has HBV.
- Hepatitis B surface antibody : This test can show if a person is immune and protected against HBV. A positive result indicates that the person has overcome a past HBV infection or it is the result of receiving the hepatitis B vaccine.
- Hepatitis B core antibody : This test looks for another antibody in the HBV, but this one does not provide protection. A positive result indicates that a person had a past infection or currently has HBV.
Some people with certain risk factors for hepatitis B infection, such as those who inject drugs, pregnant people, and other populations, may require testing postvaccination to check their immunity.
Laboratory Tests And Clinical Follow
A venous blood sample was collected prior to administration of the first vaccination and 1 month after administration of the third dose. Baseline HBs Ag status was checked by enzyme-linked immunosorbent assay with kits from DiaSorin S.p.A., Saluggia, Italy. Immunoglobulin G antibodies for HBs Ag were also assayed for by enzyme-linked immunosorbent assay with kits from the same company. The serum samples were tested blindly. The test results were interpreted according to the instructions supplied with the kits. Anti-HBs levels above 1 × 103 IU/ml were defined as seroconversion, whereas seroprotection was defined as the presence of a postimmunization anti-HBs titer of 10 × 103 IU/ml . When the titer of the undiluted serum sample was > 1,000 × 103 IU/ml, the sera were tested after diluting the sample 1:50 in human sera negative for anti-HBs and HBs Ag.
For reactogenicity assessment, subjects were physically examined at all vaccination visits and the postvaccination blood sample visit . Parents were asked to report any adverse event assumed to be causally associated with vaccination until the total follow-up period of 12 weeks ended. In the case of such a report, the child was examined thoroughly and the details were recorded. Fever was recorded by measuring the child’s oral temperature with a standard mercury thermometer. Fever was classified as mild , moderate , or severe .
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Facts About Hepatitis B
- Two billion people, or one in three, have been infected with hepatitis B worldwide. Of these, almost 300 million live with chronic hepatitis B. This means about 1 of every 26 people throughout the world are living with a chronic hepatitis B infection.
- Each year about 900,000 people die from hepatitis B worldwide, and about 2,000 of these deaths occur in the United States.
- Hepatitis B is transmitted through blood and is 100 times more infectious than HIV. An estimated one billion infectious viruses are in one-fifth of a teaspoon of blood of an infected person, so exposure to even a very small amount, such as on a shared toothbrush, can cause infection.
- Hepatitis B is sometimes referred to as the silent epidemic because most people who are infected do not experience any symptoms.
- Liver cancer accounted for about 5% of cancer deaths in the U.S. during 2020.
- Almost half of liver cancers are caused by chronic infection with hepatitis B.
- The World Health Organization recommends the inclusion of hepatitis B vaccine in immunization programs of all countries in 2019, more than 8 of 10 infants born throughout the world received three doses of hepatitis B vaccine.
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 and COVID-19 viruses, 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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What Other Drugs Interact With Hepatitis B Vaccine
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.
- Severe Interactions of Hepatitis B Vaccine include:
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.
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
Additional Resource Links:
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Indications For Hepatitis B Vaccine
HepB vaccine is a routine childhood vaccination .
HepB vaccine also is indicated for adults who have not been previously vaccinated when any of the following is present:
A desire for protection from hepatitis B in people who have not been previously vaccinated
A sexually active lifestyle in people who are not in a long-term, mutually monogamous relationship
Need for evaluation or treatment of a sexually transmitted infection
Current or recent use of illicit injection drugs
Sex between men
Employment in which workers may be exposed to blood or other potentially infectious body fluids
Diabetes in people < 60 years and sometimes in those 60 years
End-stage renal disease
A chronic liver disorder
Household contact and/or sexual contact with people who are positive for hepatitis B surface antigen
Travel to endemic areas
Time spent in correctional facilities or in facilities that provide sexually transmitted infection treatment, HIV testing and treatment, drug abuse treatment and prevention services, services to injection-drug users or men who have sex with men, or care for patients with developmental disabilities or with end-stage renal disease
Pregnant women if at risk of infection or severe outcome resulting from infection during pregnancy
The combination HepA and HepB vaccine can be used in people 18 years who have indications for either hepatitis A or hepatitis B vaccine and who have not been previously vaccinated with one of the vaccine components.
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 have responded to the vaccine.
If you have been vaccinated by your employer’s occupational health service, you can request a blood test to see if you have responded to the vaccine.
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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 :
What Is Hepatitis B Virus
Hepatitis B virus attacks the liver. Hepatitis B virus infections are known as the “silent epidemic” because many infected people don’t experience symptoms until decades later when they develop hepatitis , cirrhosis , or cancer of the liver . Every year in the United States about 22,000 new hepatitis B infections occur and about 2,000 people die from their infections.
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Common And Local Adverse Events
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.
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.
Reactions are usually mild and transient, and include fever, irritability, restlessness and injection site reactions .
Headache, diarrhea, fever, urticaria, angioedema and injection site reactions may occur.
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:
Inhibitors of uncoating have also been investigated.
During viral synthesis
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Does The Hepatitis B Vaccine Have Side Effects
Some children will develop pain or soreness in the local area of the shot, and low-grade fever.
There is one extremely rare, but serious, side effect. About 1 out of every 600,000 doses of the hepatitis B vaccine will cause a severe allergic reaction, called anaphylaxis, with symptoms including swelling of the mouth, difficulty breathing, low blood pressure or shock. Anaphylaxis usually occurs within 15 minutes of receiving the vaccine. Although anaphylaxis can be treated, it is quite frightening. People should remain at the doctors office for about 15 minutes after getting the vaccine.
Although the hepatitis B vaccine is made in yeast cells, no one has ever been shown to be allergic to the yeast proteins contained in the hepatitis B vaccine .
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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What Are Dosages Of Hepatitis B Vaccine
Dosages of Hepatitis B Vaccine:
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
- 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
- Administer in deltoid muscle for older children and adolescents anterolateral thigh preferred for neonates/infants/small children
- Do not give intravenously/intradermal
- low blood pressure
- pain when urinating
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.
Before Taking This Medicine
Hepatitis B pediatric vaccine will not protect against infection with hepatitis A, C, and E, or other viruses that affect the liver. It may also not protect against hepatitis B if your child is already infected with the virus, even if he or she does not yet show symptoms.
Your child should not receive this vaccine if he or she ever had a life-threatening allergic reaction to any vaccine containing hepatitis B. Hepatitis B pediatric vaccine should not be given to a child who is allergic to yeast.
If your child has any of these other conditions, this vaccine may need to be postponed or not given at all:
a bleeding or blood clotting disorder such as hemophilia or easy bruising
an allergy to latex rubber or
a neurologic disorder or disease affecting the brain .
Your child can still receive a vaccine if he or she has a minor cold. If the child has a more severe illness with a fever or any type of infection, your child’s doctor may recommend waiting until the child gets better before receiving this vaccine.
Tell your doctor if you are pregnant or breastfeeding.
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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.