Emergency Hepatitis B Vaccination
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.
What Are The Possible Side Effects Of Hepatitis B Immunisation
All medicines and vaccines can have side effects. Sometimes they are serious, most of the time theyre not.
Generally, the chance of having a serious side effect from a vaccine is much lower than the chance of serious harm if you caught the disease.
Talk to your doctor about possible side effects of hepatitis B vaccines, or if you or your child have possible side effects that worry you.
Common side effects of hepatitis B vaccines include:
- soreness where the needle went in
- low-grade fever
- body aches.
The Consumer Medicine Information links in How do you get immunised against hepatitis B? list the side effects of each vaccine.
Incidence Of Acute Hepatitis B In Australia
Newly acquired cases of hepatitis B virus infection in Australia mostly occur in young adults, through:65
- injecting drug use
- skin penetration procedures
- sexual contact
Between 2006 and 2015, the notification rate of newly acquired hepatitis B in Australia declined from 1.4 to 0.6 per 100,000 population.64
Since 2001, the rate of diagnosis of newly acquired infections has declined substantially among people aged < 29 years. The decline has been less among people aged 30 years.64,66,67 However, some new hepatitis B virus infections are asymptomatic and may go undetected.
Similar to chronic infection, the incidence of, and hospitalisation rates due to, acute hepatitis B are higher among Aboriginal and Torres Strait Islander people than the general Australian population.64
Hepatitis B vaccines are prepared using recombinant technology. After purification, the hepatitis B surface antigen protein is adsorbed onto elemental aluminium . Hepatitis B vaccines may contain up to 1% yeast proteins (but no yeast DNA
The Engerix-B and H-B-Vax II vaccines are manufactured by different processes, and the HBsAg content of equivalent doses of these 2 vaccines is different. The HBsAg content of the paediatric formulations of these 2 vaccines is half that of the corresponding manufacturers adult formulation.
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Immunisation Against Hepatitis B
The current Australia-wide immunisation program is necessary to protect all children from hepatitis B infection.
A full course of hepatitis B injections must be given for a child to be protected. It is recommended that this course begins within 24 hours of birth with a vaccine against hepatitis B alone. Further doses are routinely given at 2 months, 4 months and 6 months, as a combination vaccine.
Immunisation is the best protection against hepatitis B infection. In Victoria a free hepatitis B vaccine is available for a number of groups at high risk, including men who have sex with men, and people living with HIV.
The adult course involves 3 doses of the vaccine over 6 months and gives protection to about 95 per cent of people. Once you have had the 3 doses, you can have a blood test to see if you are protected.
People With Other Medical Conditions
People with chronic liver disease and/or hepatitis C are recommended to receive hepatitis B vaccine if they are not immune
Hepatitis B vaccination is recommended for people with chronic liver disease and/or hepatitis C who are seronegative for hepatitis B. This is because they may have an increased risk of hepatitis B and/or severe liver disease after hepatitis B.11
Adult-formulation hepatitis B vaccine should be given in a 3-dose schedule. See Table. Monovalent hepatitis B vaccines for adolescents and adults in Vaccines, dosage and administration.
Levels of antibody to hepatitis B surface antigen should be checked after the vaccination course. See Serological testing after hepatitis B vaccination.
The combination hepatitis A-hepatitis B vaccine may be appropriate for people with chronic liver disease and/or hepatitis C if they are not immune to either disease. This is because they have an increased risk of hepatitis B and/or severe liver disease after hepatitis A and B. This is usually given in 3 doses using Twinrix . See Table. Combination hepatitis A-hepatitis B vaccines in Vaccines, dosage and administration.
Low-birthweight and preterm newborns do not respond as well to hepatitis Bcontaining vaccines as full-term infants.12-14
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What Are The Symptoms Of Hepatitis B
Some people may exhibit symptoms of acute Hepatitis B, but a majority of the people with chronic Hepatitis B can remain symptom-free for 20-30 years. Serious liver damage can occur in 15-25% of the people with chronic Hepatitis B such as cirrhosis of the liver, liver failure and liver cancer. Some people still may not know they have liver disease caused by Hepatitis B due to lack of symptoms only blood tests for liver function may reveal abnormalities.
Symptoms of acute Hepatitis B virus infection will typically manifest in older children and adults. About 70% of adults and children over the age of 5 with the infection will develop symptoms.
Symptoms of acute Hepatitis B can include:
- Fever
- Jaundice
- Joint pain
Typically, symptoms develop an average of 90 days after exposure to the virus, but they can appear anytime between 6 weeks and 6 months after initial exposure.
Symptoms may only last a few weeks, but sometimes can persist for up to 6 months. Many infected with the Hepatitis B virus show no symptoms, but they can still spread the disease.
Visit your doctor if you think you may have Hepatitis B. Since symptoms are often not seen nor experienced, the disease usually needs to be diagnosed via blood tests. Such tests search for the presence of antigens and antibodies to help determine if you have:
- Acute or chronic infection
- An immunity to Hepatitis B
- The potential to benefit from vaccination
Where Can I Get Vaccinated
The best place to go for vaccinations is your family medical clinic. They have your medical records and can check to see if youve already had a particular vaccination. Either your doctor or a nurse can give the vaccination.If you dont have a family doctor, you can go to one of the after-hour medical clinics. Ring them first to make sure they can help you with the vaccination you need.You can find a clinic near you on the Healthpoint website. Put in your address and region, and under Select a service, click on GPs/Accident & Urgent Medical Care.Vaccines on the National Immunisation Schedule are free. Other vaccines are funded only for people at particular risk of disease. You can choose to pay for vaccines that you are not eligible to receive for free.
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Side Effects Of Hepatitis B Vaccines
Immunisations containing components to protect against hepatitis B are effective and safe, although all medication can have unwanted side effects.
Side effects from the vaccine are uncommon and usually mild, but may include:
- Localised pain, redness and swelling at the injection site.
- Low-grade temperature .
- In children being unsettled, irritable, tearful, generally unhappy, drowsy and tired.
- Occasionally, an injection-site lump that may last many weeks, but for which treatment is not needed.
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 and treatments that inactivated any possible contaminating virus. 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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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.
What Are The Risks Of Hepatitis B
About 90 per cent of adults infected with Hepatitis B recover within six months. However about 90 per cent of infected babies and 10 per cent of infected adults will develop chronic infection for life. Chronic Hepatitis B can cause cirrhosis of the liver, liver cancer, liver failure and death. A person with chronic Hepatitis B also has higher risk of being infected with another viral Hepatitis.
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About The Hepatitis B Vaccine Booster
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Getting the vaccine booster
Request the vaccine and complete your confidential online questionnaire. One of our clinicians will check your suitability and contact you via your Patient Record. Once approved, you can select at which LloydsPharmacy store you would like to be vaccinated and call to book your appointment.
The vaccine comes as one injection, usually given in the upper arm.
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Effectiveness
More than 9 out of 10 will be protected after receiving a booster vaccine. 4 weeks after this booster you may wish to undergo a blood test to check that you are immune.
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Side effects
Most people experience no side effects from this vaccine. However, you may experience pain, swelling or reddening of the skin at the injection site, fatigue, headache, mild fever, nausea, vomiting, decreased appetite and diarrhoea.
Managing Fever After Immunisation
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.
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Before Taking This Medicine
Hepatitis A and B vaccine will not protect you against infection with hepatitis C or E, or other viruses that affect the liver. It will also not protect you from hepatitis A or B if you are already infected with the virus, even if you do not yet show symptoms.
You should not receive this vaccine if you are allergic to yeast or neomycin, or if you have ever had a life-threatening allergic reaction to any vaccine containing hepatitis A or hepatitis B.
Before receiving this vaccine, tell the doctor if you have:
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an allergy to latex rubber or
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a weak immune system caused by disease, bone marrow transplant, or by using certain medicines or receiving cancer treatments.
You can still receive a vaccine if you have a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.
FDA pregnancy category C. Tell your doctor if you are pregnant. It is not known whether hepatitis A and B vaccine will harm an unborn baby. However, not vaccinating the mother could be harmful to the baby if the mother becomes infected with a disease that this vaccine could prevent. Your doctor will decide whether you should receive this vaccine, especially if you have a high risk of infection with hepatitis.
If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of this vaccine on the baby.
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.
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Why It Is Used
Hepatitis B virus causes a liver infection that can lead to serious complications, including liver cancer. It is common in people throughout the world, particularly in Asia and sub-Saharan Africa.
The Canadian National Advisory Committee on Immunization recommends hepatitis B immunization for all children. Pregnant women and other adults who do not have immunity and who have a high chance of exposure should be vaccinated.
Do I Need To Pay For Hepatitis B Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
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Who Should Get A Hepatitis B Vaccine
Vaccination against hepatitis B is recommended for everyone. But, some groups are at an increased risk. These include the following individuals:
- Men who have sex with men
- Inject drugs or share needles
- Live with a person with chronic hepatitis B
- Hemodialysis patients
- Travellers to regions with hepatitis B transmission.
Those who are allergic to products within the vaccine and some individuals with certain health conditions. Consult with a travel health specialist to learn if the vaccine is right for you and your situation.
Transmission Symptoms And Treatment
How is HBV transmitted?
HBV is transmitted through activities that involve percutaneous or mucosal contact with infectious blood or body fluids , including
- sex with an infected partner
- injection-drug use that involves sharing needles, syringes, or drug-preparation equipment
- birth to an infected mother
- contact with blood from or open sores on an infected person
- exposures to needle sticks or sharp instruments and
- sharing certain items with an infected person that can break the skin or mucous membranes , potentially resulting in exposure to blood.
How long does HBV survive outside the body?
HBV can survive outside the body and remains infectious for at least 7 days .
What should be used to clean environmental surfaces potentially contaminated with HBV?
Any blood spills should be disinfected using a 1:10 dilution of one part household bleach to 10 parts of water. Gloves should be worn when cleaning up any blood spills.
Who is at risk for HBV infection?
The following populations are at increased risk for becoming infected with HBV:
- Infants born to infected mothers
- Sex partners of infected people
- Men who have sex with men
- People who inject drugs
- Household contacts or sexual partners of known people with chronic HBV infection
- Health-care and public-safety workers at risk for occupational exposure to blood or blood-contaminated body fluids
- Hemodialysis patients
Who should be screened for HBV?
CDC recommends that the following people be screened for HBV :
- fever,
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Who Should Be Immunised Against Hepatitis B
Hepatitis B immunisation is recommended and funded for the following groups:
- all children up to their 18th birthday
- babies born to mothers with hepatitis B infection
- people who live in close contact with someone infected with hepatitis B
- anyone undergoing renal dialysis
- people who have hepatitis C infection, or who are HIV positive, or who have had a needle stick injury.
- anyone who has received immunosuppression therapy of at least 28 days or has had solid organ or bone marrow transplant.
Hepatitis B immunisation is also recommended, but not funded, for:
- workers who are likely to come into contact with blood products, or who are at increased risk of needlestick injuries, assault, etc.
- people who change sex partners frequently such as sex workers
- people who regularly receive blood transfusions such as people with haemophilia
- prison inmates
- current or recent injecting drug users
- migrants and travellers from or to areas with intermediate or high rates of hepatitis B such as the Asia and Pacific region.
Measurement Of Infections As A Way To Measure Long
gives an overview of follow-up studies using anti-HBc, HBsAg, or HBV DNA to measure infections and protection in vaccine recipients.
Breakthrough infections occur in 0%17.7% of the general population and in up to 33.3% in children of carrier mothers after 15 years of follow-up . In long-term follow-up studies, breakthrough infections do occur, illustrated by the seroconversion of anti-HBc antibodies, but few clinically significant infections are diagnosed and few new carriers are reported .
From a public health point of view, the likelihood of becoming a hepatitis B carrier is even more important. Viviani et al recently published the evaluation of 24 years of a hepatitis B vaccination program in The Gambia: 67% vaccine efficacy against development of anti-HBc and 96.6% vaccine efficacy against carriage was reported. The impact on hepatocellular cancer had already been seen: the risk of hepatocellular carcinoma attributable to HBV at age < 50 years was 70%80% lower than that for historical cohorts.
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