Friday, November 25, 2022

What Is The Schedule For Hepatitis B Vaccine For Adults

Tetanus And Diphtheria Vaccine

Hepatitis B Vaccine: Routine and Catch-up Schedule

Td is a two-in-one vaccine. It protects people against tetanus and diphtheria. The National Advisory Committee on Immunization strongly recommends that all Canadians receive a primary immunizing course of tetanus toxoid in childhood followed by routine booster doses every 10 years.

The Ministry of Health and Long-Term Care recently introduced one lifetime dose of the pertussis vaccine for adults to the Publicly Funded Immunization Schedules for Ontario. All adults 19 to 64 years of age, who have never received the Tdap vaccine in adolescence, are now eligible to receive one lifetime dose of the vaccine. This lifetime dose replaces one of the Td booster doses given every 10 years.

Parents, grandparents or other adult household contacts of newborns, infants and young children as well as health care workers are considered a priority to receive the Tdap vaccine.

What is tetanus?

Tetanus or lockjaw is a serious disease that can happen if dirt with the tetanus germ gets into a cut in the skin. Tetanus germs are found everywhere, usually in soil, dust and manure. It does not spread from person to person. Tetanus causes cramping of the muscles in the neck, arms, leg and stomach, and painful convulsions which can be severe enough to break bones. Even with early treatment, tetanus kills two out of every 10 people who get it.

What is diphtheria?

Immunogenicity Efficacy And Effectiveness


Protective concentrations of antibody against HA develop in 95% to 100% of vaccine recipients after 1 dose of HA vaccine, and nearly 100% seroconvert after receiving 2 doses of vaccine.


HA vaccines are at least 90% to 97% effective in preventing clinical HA illness.


The use of HA vaccine in susceptible populations interrupts HA outbreaks. The protective efficacy of HA vaccine when used within 1 week of exposure is approximately 80%.

Immunizing Agents Available For Use In Canada

Hepatitis A-containing vaccines

  • AVAXIM® and AVAXIM®-Pediatric , Sanofi Pasteur SA , Sanofi Pasteur Ltd.
  • HAVRIX®1440 and HAVRIX®720 Junior , GlaxoSmithKline Inc.
  • TWINRIX® and TWINRIX®Junior , GlaxoSmithKline Inc. Refer to Hepatitis B Vaccine in Part 4 for additional information about HAHB vaccine.
  • VAQTA® , Merck Canada Inc.
  • ViVAXIM® , Sanofi Pasteur Ltd.

Human immunoglobulin

  • GamaSTAN® , Grifols Therapeutics LLC.

Standard human immunoglobulin is a sterile, concentrated solution for intramuscular injection containing 15% to 18% immunoglobulin. It is obtained from pooled human plasma from screened donors and contains mainly IgG with small amounts of IgA and IgM. For complete prescribing information, consult the product leaflet or information contained within the product monograph available through Health Canada’s Drug product database.

Refer to Contents in Immunizing Agents Available for Use in Canada in Part 1 for lists of vaccines and passive immunizing agents available for use in Canada and their contents.

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Immunogenicity In Pediatric Patients:

In clinical trials with 242 children aged 6 months to, and including, 10 years given 10 mcg at months 0, 1, and 6, the seroprotection rate was 98% 1 to 2 months after the third dose the GMT of seroconverters was 4,023 mIU/mL.

In a separate clinical trial including both children and adolescents aged 5 to 16 years, 10 mcg of ENGERIX-B was administered at 0, 1, and 6 months or 0, 12, and 24 months . Immediately before the third dose of vaccine, seroprotection was achieved in 92.3% of subjects vaccinated on the 0-, 1-, and 6-month schedule and 88.8% of subjects on the 0-, 12-, and 24-month schedule . One month following the third dose, seroprotection was achieved in 99.5% of children vaccinated on the 0-, 1-, and 6-month schedule compared to 98.1% of those on the 0-, 12-, and 24-month schedule. GMTs were higher for children receiving vaccine on the 0-, 1-, and 6-month schedule compared to those on the 0-, 12-, and 24-month schedule . The clinical relevance of this finding is unknown.

How Is Hepatitis B Diagnosed

Recommended Adult Immunization Schedule

A simple blood test can tell your doctor if you have the hepatitis B virus now or if you had it in the past. Your doctor also may be able to tell if you have had the vaccine to prevent the virus.

If your doctor thinks you may have liver damage from hepatitis B, he or she may use a needle to take a tiny sample of your liver for testing. This is called a liver biopsy.

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Immunogenicity And Effectiveness/efficacy Of Accelerated Vaccination Schedules In Different Populations

Table 1Overview of immunogenicity results according to vaccination schedule, in different populations

Merck recombinant hepB 0 1 6
Merck recombinant hepB 0 1 2
Merck recombinant hepB 0 1 12
GenHevac B 0 1 2 12
GenHevac B 0 1/3 3/4 12
GenHevac B 0 1 2
GenHevac B 0 1/3 3/4
Bevac 0 1 2
EngerixB 0 1 2
RecombivaxHB 0 6
RecombivaxHB 0 6
RecombivaxHB 0 6
RecombivaxHB 0 6

*Bold values refer to a higher antigen dosage schedule expressed in months 1/4 1/3 1/2 3/4 3/4 therefore correspond to 7, 10, 14, 21days, and 1.5months , respectively type of vaccination schedule: coded as S , SS , A , SA or P parentheses indicate schedules without the final dose § M/F: male/female ratio NA: not applicable ¶numbers and percentages either reported in the paper or calculated from the reported values.

Healthy adolescents

Few studies have examined the use of accelerated hepatitis B vaccination schedules in adolescents. Nevertheless, since the immunogenicity of many vaccines, including hepatitis B vaccines, is higher in younger persons, the results of studies in healthy adults can safely be extrapolated to younger age groups.

Healthy adults

Travellers to areas of intermediate or high endemicity

Drug users

Lugoboni et al found a similar immunogenicity as compared with the general population, using the combined vaccine according to a standard vaccination schedule against hepatitis A and B in a population of drug users.

Measles Mumps Rubella And Varicella Vaccine

The Ministry of Health and Long-Term Care recently introduced a new measles, mumps, rubella and varicella vaccine to the Publicly Funded Immunization Schedules for Ontario.

Immunization against measles, mumps and rubella is required by law for all children attending school in Ontario, unless exempted. Immunization against varicella is also required for children born in 2010 or later.

What is measles?

Measles can be a serious infection. It causes high fever, cough, rash, runny nose and watery eyes. Measles lasts for one to two weeks. Ear infections or pneumonia can happen in one out of every 10 children with measles. Measles can also be complicated by encephalitis, an infection of the brain, in about one out of every 1,000 children with measles. This may cause brain damage and developmental delays. Measles can also make a pregnant woman have a miscarriage or give birth prematurely.

Measles spreads from person to person very easily and quickly. People can get measles from an infected person coughing or sneezing around them or simply talking to them.

What is mumps?

Mumps can cause very painful, swollen testicles in about one out of four teenage boys or adult men, and painful infection of the ovaries in one out of 20 women. Mumps infection during the first three months of pregnancy may increase the risk of miscarriage. Mumps can cause deafness in some people.

What is rubella ?

What is varicella ?

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Blood Tests To Diagnose Hepatitis B

Blood tests are done to help diagnose hepatitis B. They include:

  • Hepatitis B antigens and antibodies. These help tell if you are or were infected with the virus. They also can show if you have been immunized and if you have long-term infection. You also may get tested for the virus’s genetic material . For more information, see Hepatitis B Virus Tests.
  • Tests to see if the hepatitis A, hepatitis C, or Epstein-Barr viruses are causing your hepatitis.
  • Tests to see if you are infected with hepatitis D along with hepatitis B.
  • Hepatitis B and C: Should I Be Tested?

How To Get Vaccinated Against Hepatitis B

ACP and CDC issue recommendations for hepatitis B screening, vaccination, and care

All babies in the UK born on or after 1 August 2017 are given 3 doses of hepatitis B-containing vaccine as part of the NHS routine vaccination schedule. These doses are given at 8, 12 and 16 weeks of age.

Babies at high risk of developing hepatitis B infection from infected mothers are given additional doses of the hepatitis B vaccine at birth, 4 weeks and 1 year of age.

If you think you’re at risk and need the hepatitis B vaccine, ask your GP to vaccinate you, or visit any sexual health or genitourinary medicine clinic.

If your GP or nurse is unable to offer you the hepatitis B vaccine because of a temporary shortage in supply, you may need to wait longer for the vaccine. For more information, read What to do if you have to wait for a dose of hepatitis B vaccine .

If your job places you at risk of hepatitis B infection, it’s your employer’s responsibility to arrange vaccination for you, rather than your GP. Contact your occupational health department.

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Use With Other Vaccines:

The ACIP states that, in general, simultaneous administration of certain live and inactivated pediatric vaccines has not resulted in impaired antibody responses or increased rates of adverse reactions.17 Separate sites and syringes should be used for simultaneous administration of injectable vaccines.

Can Hepatitis B Be Prevented

The hepatitis B vaccine is the best way to prevent infection. The vaccine is a series of 3 or 4 shots. Check with your doctor or check your provincial immunization schedule to see if you or your child needs the hepatitis B vaccine.

A combination vaccine that protects against both hepatitis B and hepatitis A also is available.

To avoid getting or spreading the virus to others:

  • Use a condom when you have sex.
  • Don’t share needles.
  • Wear disposable or plastic gloves if you have to touch blood.
  • Don’t share toothbrushes or razors.
  • Don’t get a tattoo, or make sure that the needles used have been cleaned properly and are sterile.

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Global Burden Of Disease

Approximately two billion people worldwide had been exposed to HBV in 1995. In 2015, based on serological data, around 3.5 percent of the general population globally were infected with HBV and more than 250 million people were estimated to have chronic infection and these people remain at risk of developing cirrhosis and hepatocellular carcinoma. More than 90 percent of individuals with chronic HBV resided in the AsiaPacific region, where most countries have high prevalence rates of HBV infection and more than 99 percent of HBV-infected people in this region acquired infection through vertical transmission from their mother or in early childhood. As an example of this risk, 22.8 million out of 80 million people living in China with chronic HBV infection are women of child-bearing age. Acquisition of HBV during adulthood is associated with a high rate of symptomatic hepatitis but a low rate of chronic infection.

Hepatitis B Vaccine On The Nhs

Recommended Adult Immunization Schedule

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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Are There Any Known Side Effects Of Prehevbrio

As with all medications and vaccines, you may experience some side effects after getting PreHevbrio. The PROTECT and CONSTANT studies provide information about this vaccines side effects.

PreHevbrios most common side effects are similar to other vaccines, such as the flu shot. These include:

  • Pain and soreness where you received your vaccine

  • Headache

  • Tiredness

  • Muscle pain

And compared to vaccines like Engerix-B, PreHevbrio is more likely to cause these types of temporary side effects.

People With Chronic Hepatitis B

The vaccine does not affect people with chronic hepatitis B virus infection there are no therapeutic benefits or associated adverse events. The vaccine is also safe in people who are already immune to hepatitis B through past natural infection, but it offers no additional benefit.

Hepatitis B is an infection caused by hepatitis B virus. It affects the liver.

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What Are Warnings And Precautions For Hepatitis B Vaccine


This medication contains the hepatitis b vaccine. Do not take Engerix B or Recombivax HB if you are allergic to the hepatitis b vaccine or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.


Pneumococcal Conjugate Vaccine Given At 2 Months 4 Months And 12 Months

Low Prevalence of Hepatitis B Vaccination Among People Receiving HIV Care

The pneumococcal conjugate vaccine protects children against invasive pneumococcal infections such as pneumonia, bacteraemia and meningitis .

What is invasive pneumococcal disease ?

IPD is an infection caused by a type of bacteria called streptococcus pneumoniae . This type of bacteria can cause any of the following:

  • pneumonia
  • bacteraemia
  • meningitis

Pneumococcal infection is also a frequent cause of ear infections .

Pneumonia, bacteraemia and meningitis can sometimes cause death or long lasting complications such as deafness, especially in people with a high-risk medical condition.

Sometimes antibiotics do not work against the pneumococcal infection . Antibiotic resistance occurs when drugs, used to treat the infection, are no longer effective in killing or stopping the growth of particular microorganisms, such as pneumococcal bacteria. When there is antibiotic resistance, it is more difficult to treat the infection.

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What Are Dosages Of Hepatitis B Vaccine

Dosages of Hepatitis B Vaccine:

Intramuscular suspension

  • 40 mcg/ml

Intramuscular suspension

  • 5 mcg/0.5 ml
  • 10 mcg/0.5 mg

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



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.

Blood Tests To Check For Liver Damage

Blood tests may be done to help find out if your liver has been damaged. They include:

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Babies And Children Can Develop Chronic Hbv

You may be wondering why the recommendations for the HBV vaccine start on the first day of life.

Adults who contract HBV will likely not experience long-term complications from hepatitis B. But the same is not the case for babies. As many as of babies who contract an HBV infection at birth from their mothers become chronically infected with HBV.

Children between the ages of 1 and 5 who get an HBV infection have a 25 percent of people who become chronically infected during childhood will develop liver cancer or cirrhosis. Thats why pediatricians want children to have immunity from HBV from the earliest possible age. Many babies and children exposed to HBV receive post-exposure prophylaxis, which decreases chance of infection.

If youre pregnant, youll most likely have a blood test to see if youre positive for hepatitis B. This allows doctors to find out if theres a chance that you could pass on the virus. These tests are highly sensitive and have a good accuracy rate, but they arent perfect. Additionally, a pregnant person may become infected between the time of the test and giving birth. The first dose of the vaccine given at birth lowers the risk of a newborn baby contracting hepatitis B.

Emergency Hepatitis B Vaccination

Recommended Adult Immunization Schedule

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.

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When Should You Call Your Doctor

If you see a person with hepatitis B become unconscious, call 911 or other emergency services.

if you have been diagnosed with hepatitis B and you have severe dehydration or these signs of liver failure:

  • Extreme irritability.
  • Extreme sleepiness.
  • Swelling of the arms, legs, hands, feet, belly, or face.
  • Heavy bleeding from the nose, mouth, or rectum , or under the skin.
  • Yellowing of the skin and the whites of the eyes.
  • You have risk factors for hepatitis B, such as handling blood or body fluids as a routine part of your job or having many sex partners.
  • You have any symptoms of hepatitis B .
  • Someone in your household has been diagnosed with hepatitis B.
  • Your sex partner has been diagnosed with hepatitis B.
  • You have been bitten by or exposed to the blood or body fluids of someone who has hepatitis B.

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