HEPATITIS B VACCINE

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Last Updated : 1/9/2014
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Nitin Shah
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What is hepatitis B?
Hepatitis B (HBV) is a type of virus that leads to jaundice and infective hepatitis. HBV leads to acute hepatitis and most of the patients recover. 5 - 10% develop chronic carrier state. Again of these carriers, 30% will develop chronic liver disease and some will develop liver cancer. 1 - 2% of patients with HBV infection develop fulminant hepatitis which carries > 80% mortality.

What are the modes of transmission of HBV?
Vertical transmission occurs from Hepatitis B positive pregnant women to their babies during the perinatal period. Transmission may also occur due to close contact e.g. amongst family members or at day care centers. It can also spread via blood products, contaminated needles, surgical instruments, IV drug abuse, tattooing, acupuncture needles, ear piercing etc. Last is the sexual route of transmission, which occurs when one partner is infected.

What is hepatitis B vaccine?
Hepatitis B vaccine protects against infection by HBV. Ideally it should be given to every individual.

What is the schedule of Hepatitis B immunization?
Schedule consists of giving 3 doses at birth, 6 weeks along with polio vaccine/DPT and 3rd dose can be given at 6 months. A booster is not required.

What if the child comes late for subsequent doses?
There is no need to restart the course. Instead just complete the remaining doses as per original schedule. However such delays are not desirable as the child remains unprotected till the course of 3 doses is completed.

What are the side effects of Hepatitis B vaccine?
The side effects of the vaccines are very few if any. Local reactions including redness, pain and swelling at injection site.

What about immunocompromised children?
Children with leukemia, on chemotherapy, multi - transfused thalassemics, patients on high dose long-term steroids and patients on hemodialysis have poor seroconversion following conventional schedule. Hence it is recommended to double the dose of vaccine. Even children with Down's syndrome show poor seroconversion & titres and should be given double the normal doses

Should Hepatitis B vaccine be given to a carrier or to a patient who has recovered from HBV infection?
Neither the carrier nor the patient who has recovered needs Hepatitis B vaccine. In fact, a patient of HBV infection develops protective antibodies to surface antigen (anti - HBs) on recovery. There is no risk associated with vaccination, but it is a total waste.

Can you use different Hepatitis B vaccines interchangeably?
If there is no other option, yes, they can be interchanged.

Can you give Hepatitis B vaccine along with other vaccines?
Yes, it can be given together with other vaccines. The vaccines should be given on the same day but at different sites using different syringes or as combination vaccine like DPT+Hepatitis B vaccine.

References

Contributor Information and Disclosures Nitin Shah
Consultant Pediatrician, B J Wadia Hospital for Children, Mumbai, India


First Created : 1/9/2001
References
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