Hepatitis B vaccine

Jump to navigation Jump to search

Hepatitis Main Page

Hepatitis B

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Hepatitis B from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Ultrasound

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hepatitis B vaccine On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hepatitis B vaccine

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hepatitis B vaccine

CDC on Hepatitis B vaccine

Hepatitis B vaccine in the news

Blogs on Hepatitis B vaccine

Directions to Hospitals Treating Hepatitis B

Risk calculators and risk factors for Hepatitis B vaccine

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Hepatitis B Vaccine

Hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. Hepatitis B vaccination is the most effective measure to prevent HBV infection and its consequences. Since they were first issued in 1982, recommendations for hepatitis B vaccination have evolved into a comprehensive strategy to eliminate HBV transmission in the United States.

The vaccine is highly effective. In endemic countries with high rates of hepatitis B infection, vaccination of newborns has not only reduced the risk of infection, but has also led to marked reduction in liver cancer. This was reported in Taiwan where the implementation of a nationwide hepatitis B vaccination program in 1984 was associated with a decline in the incidence of childhood hepatocellular carcinoma.[1]

Recombinant DNA-derived vaccines against HBV have been available for more than two decades. The primary hepatitis B immunization series conventionally consists of three doses of vaccine. Vaccination of infants and, in particular, delivery of hepatitis B vaccine within 24 hours of birth is 90–95% effective in preventing infection with HBV as well as decreasing HBV transmission if followed by at least two other doses. WHO recommends universal hepatitis B vaccination for all infants, and that the first dose should be given as soon as possible after birth.[2]This strategy has resulted in a dramatic decrease in the prevalence of CHB among young children in regions of the world where universal infant vaccination programs have been implemented. A proportion of vaccinated children (5–10%) have a poor response to vaccination, and will remain susceptible as adults to acquisition of HBV infection.:[3][4]

Type of the vaccines

The vaccine was originally prepared from plasma obtained from patients who had long-standing hepatitis B virus infection. However, currently, these are more often made using recombinant DNA technology, though plasma-derived vaccines continue to be used; the two types of vaccines are equally effective and safe.[5]

  • Plasma the (first generation hepatitis B vaccine)
  • recombinant
    • Yeast-derived recombinant
    • mammalian cell-derived recombinant


Patients with HIV appear to have inferior antibody responses to hepatitis B vaccination.[6] This is not surprising, because some HIV-positive people have damaged immune systems: this may happen even before opportunistic infections take hold, thus justifying a diagnosis of AIDS.

It is not known whether vaccination with hepatitis B vaccine would cause rejection of a donor's blood by a blood bank that routinely tests blood for hepatitus B antibodies, as most now do—and have been doing since the mid-1980's. This is worth discussing with a doctor.

Vaccination recommendation

Hepatitis B vaccination recommendation in Infant and neonates include:[3]

  • All infants should receive their first dose of hepatitis B vaccine as soon as possible after birth, preferably within 24 hours, followed by two or three doses.

Hepatitis B vaccination recommendation in adults include:[7][8]

  • Any person who wants to be protected from HBV infection
  • Patient with diabetes mellitus (age 60 years or older with diabetes mellitus, at the discretion of the treating clinician)
  • Patient with end-stage renal disease, including patients receiving hemodialysis; HIV infection; or chronic liver disease
  • Sexually active and not in a long-term, mutually monogamous relationship (e.g., more than 1 sex partner during the previous 6 months)
  • Seeking evaluation or receiving treatment for a sexually transmitted infection (STI)
  • A male who has sex with males
  • A current or recent injection-drug user
  • At occupational risk of infection through exposure to blood or blood-contaminated body fluids
    • Health care worker
    • Public safety worker
    • Trainee in a health professional or allied health school
  • Residents or staff of an institution for persons with developmental disabilities
  • Sex partner or household member of a person who is chronically infected with HBV (HBsAg-positive)
  • People living in correctional facilities
  • All teenagers ages 18 and younger who are not fully vaccinated
  • Planned travel to a country with high or intermediate prevalence of endemic HBV infection
    • Hepatitis B vaccination should be administered to all unvaccinated people traveling to areas with intermediate to high prevalence of chronic hepatitis B (HBV surface antigen prevalence ≥2%)

Recommended schedule

The vaccination schedule

Licensed hepatitis B vaccines in the United States

Currently licensed hepatitis B vaccines in the United States:[7]|

  • Single-antigen hepatitis B vaccines
    • ENGERIX-B
    • RECOMBIVAX HB
  • Combination vaccines
    • PEDIARIX: Combined hepatitis B, diphtheria, tetanus, acellular pertussis (DTaP), and inactivated poliovirus (IPV) vaccine. Cannot be administered before age 6 weeks or after age 7 years.
    • TWINRIX: Combined Hepatitis A and hepatitis B vaccine. Recommended for persons aged ≥18 years who are at increased risk for both Hepatitis A virus and HBV infections.
    • COMVAX: (discontinued for purchase as of December 2014): Combined hepatitis B-Haemophilus influenzae type b (Hib) conjugate vaccine. Cannot be administered before age 6 weeks or after age 71 months.

Recommended doses of hepatitis B vaccines

Recommended doses of hepatitis B vaccines[7]

Interrupted Vaccination

interruption between doses of hepatitis B vaccination:[7]

  • After the first dose, the second dose should be administered as soon as possible
  • The second and third doses should be separated by an interval of at least 8 weeks
  • Only the third dose is delayed, it should be administered as soon as possible

Contraindications

Hepatitis B vaccine is contraindicated in a person who has experienced a serious systemic or anaphylactic reaction to a prior dose of the vaccine.

References

  1. Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS, Liang DC, Chau WY, Chen DS (1997). "Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group". N Engl J Med. 336 (26): 1855–9. PMID 9197213.
  2. Ni JD, Xiong YZ, Wang XJ, Xiu LC. Does increased hepatitis B vaccination dose lead to a better immune response in HIV- infected patients than standard dose vaccination: a meta-analysis? Int J STD AIDS. 2013;24(2):117–22.
  3. 3.0 3.1 World Health Organization, Guidelines for the Prevention, Care, and Treatment of persons with chronic Hepatitis B Infection. (March 2015). http://apps.who.int/iris/bitstream/10665/154590/1/9789241549059_eng.pdf Accessed on October 4th, 2016
  4. Liu CJ, Liou JM, Chen DS, Chen P J.Natural course and treatment of dual hepatitis B virus and hepatitis C virus infections. J Formos Med Assoc Taiwan. 2005;104(11):783–91.
  5. Szmuness W, Stevens CE, Harley EJ, Zang EA, Oleszko WR, William DC; et al. (1980). "Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States". N Engl J Med. 303 (15): 833–41. doi:10.1056/NEJM198010093031501. PMID 6997738.
  6. Pasricha N, Datta U, Chawla Y, Singh S, Arora S, Sud A, Minz R, Saikia B, Singh H, James I, Sehgal S (2006). "Immune responses in patients with HIV infection after vaccination with recombinant Hepatitis B virus vaccine". BMC Infect Dis. 6: 65. PMID 16571140.
  7. 7.0 7.1 7.2 7.3 Centers for Disease Control and Prevention. Hepatitis B (2016) http://www.cdc.gov/hepatitis/hbv/hbvfaq.htm#vaccFAQ Accessed on September 29, 2016
  8. Centers for Disease Control and Prevention. Infectious Diseases Related to Travel. Hepatitis B. (2015) http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/hepatitis-b#4621 Accessed on October 4th, 2016

See also

Template:Vaccines Template:WikiDoc Sources