Hepatitis Immunizations (cont.)
Hepatitis B
Hepatitis B has been referred to as "serum hepatitis"
because it usually is spread by the transfer of infected blood or serum (for
example, through needle sticks, blood transfusions, hemodialysis, and
childbirth). Hepatitis B also is spread through sexual intercourse and may be
passed from mother to child. Inadvertent exposure to infected blood or body
fluids may occur during tattooing, body piercing, or when sharing razors or
toothbrushes with an infected person. Persons infected with hepatitis B may be
asymptomatic or may develop fatigue, jaundice, and weight loss. Rarely
- though
more commonly than with hepatitis A - acute infection with hepatitis B can cause liver failure and
death.
Up to 95% of infected adults are able to clear the
hepatitis B virus from their body and become immune to further infections with
hepatitis B. However, some people are not able to clear the hepatitis B virus
and it progresses to chronic (persistent) infection and inflammation of the liver.
Approximately 90% of infants infected at birth and 25%–50% of infected children
aged 1–5 years have chronic persistent infection.
Chronic infection may be mild or may damage the liver. The majority of
individuals with chronic hepatitis B who clear the virus and are "cured" still have detectable virus in the liver.
However, the importance of this fact is unclear since there is no evidence of consequences to the presence of the virus except that it can be reactivated with immunosuppression.
Individuals with hepatitis B virus only in the liver are not infectious. Approximately 20% of people with chronic hepatitis B
infection have their lives shortened by complications of liver disease,
cirrhosis, or liver cancer.
Vaccination has reduced the number of new cases of hepatitis B by more than
75% in the United States. The hepatitis B vaccine contains a protein (antigen)
that stimulates the body to make protective antibodies. Examples of hepatitis B
vaccines available in the United States include hepatitis
b vaccine-injection (Engerix-B, Recombivax-HB). Three doses (given at 0, 1,
and 6 months) are necessary to assure protection.
There are also combination
vaccines on the market that provide protection against hepatitis B and other
diseases. For example:
Hepatitis B vaccines are effective and safe. Up to 95%
of vaccinated individuals develop protective antibodies when they get the
vaccine and are protected from infection with hepatitis B. Among individuals at
high risk for infection with hepatitis B include:
- healthcare workers,
- high-risk public
safety workers,
- dialysis patients, and
- sexual partners of infected persons
A
blood test for hepatitis B antibodies is recommended after vaccination to ensure
that antibodies have been produced. For the few who do not form antibodies,
revaccination may improve the response, especially in infants. However, a small
proportion of individuals will never respond to hepatitis B vaccination. Side
effects from the vaccine usually are mild, primarily soreness at the site of
injection. The risk of serious allergic reactions (anaphylaxis) is less than one
per million doses.
In the United States, hepatitis B vaccination is
recommended for all infants at birth. Older children and adolescents should
receive the vaccine if they did not receive it at birth. Adults in high risk
situations also are advised to receive hepatitis B vaccine.
This includes:
- health care workers,
- dentists,
- intimate and household contacts of patients with
chronic hepatitis B infection,
- public safety workers who may be exposed to blood
products,
- men who have sex with men,
- individuals with multiple sexual partners,
- dialysis patients,
- injection drug users,
- persons with chronic liver disease,
- residents and staff in institutions that care for persons with developmental
disabilities,
- persons infected with human immunodeficiency virus (HIV), and
- persons who require
repeated transfusions or blood products.
Centers that serve high-risk
individuals are encouraged to provide the vaccine to their clients. Such centers
include:
Some countries have a high prevalence of
hepatitis B in their population. Travelers who visit these countries for a
prolonged period of time (usually 6 months or longer) and those who may be
exposed to blood or semen should consider vaccination.
Unvaccinated individuals who are exposed to a known case of hepatitis B or to
a person at high risk for hepatitis B should be evaluated by a physician.
Examples of such exposures include needle stick injuries in health care workers
or sexual intercourse with an infected person. If the exposure is significant,
the physician will recommend vaccination and may also recommend an injection of
hepatitis B immune globulin (HBIG). HBIG is prepared from the plasma of blood
donors and contains antibodies to hepatitis B. Vaccination and HBIG can
substantially reduce the risk of disease in persons exposed to hepatitis B if
given within one week of a needle stick or two weeks of sexual intercourse.
Vaccination provides long-term immunity in people who respond to the vaccine.
There is no need for HBIG if an exposure occurs to a vaccinated person who is
known to have responded to the vaccine; however, a blood test might be drawn to
verify that the person did respond to the vaccine and form antibodies.
Infected mothers can pass hepatitis B to their newborn
infants. All pregnant women should have blood drawn to determine if they are
infected. Infants born to infected mothers should receive HBIG and hepatitis B
vaccine at birth. This is 85% to 95% effective in eliminating the risk of
hepatitis B infection in the infant.
Last Editorial Review: 3/31/2009
- hepatitis b vaccine-injection, Engerix-B, Recombivax HB - Consumer information about the medication HEPATITIS B VACCINE - INJECTION (Engerix-B, Recombivax HB), includes side effects, drug interactions, recommended dosages, and storage information. Read more about the prescription drug HEPATITIS B VACCINE - INJECTION.
- Childhood Vaccination Schedule - Read our printable children's immunization schedule and learn about vaccines for kids (Hib, polio, DTaP, MMR, HPV, flu, chickenpox, meningitis, rotavirus, pneumonia, hepatitis A and B).
- Liver Cancer - Get information on liver cancer, its symptoms, causes, diagnosis, staging, prognosis, treatment, and prevention.
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