Hepatitis B Vaccine
Mechanism :
Hepatitis B Vaccine (Recombinant) is a non-infectious subunit viral vaccine derived from hepatitis B surface antigen (HBsAg) produced in yeast cells.
Indication :
Contraindications :
Hypersensitivity to yeast or any component of the vaccine is a contraindication for its use.
Dosing :
First Dose:
Medically stable babies >2 kg body weight born to mothers who are HBsAg-negative:
0.5 ml IM within one day of birth.
Preterm babies <2 kg body weight born to mother who are HBsAg-negative: 0.5 ml IM either at time of hospital discharge or one month post birth.
For children born to HBsAg positive mothers: 0.5 ml IM in <12 hours after birth with HBIG.
If mother’s HBsAg is unknown:
0.5 ml IM <12 hours after birth with HBIG. If the baby weighs <2 kg, immediately determine the mother’s HBsAg status and if found positive administer HBIG for childe weighing >2 kg within a week.
Second dose:
To be given when child is 1-2 months old.
For children who have not been vaccinated at all since birth, they should receive three successive doses of HepB on a schedule of 0,1,2 months and 6 months as early as possible.
Minimum interval between the first and second dose is one month and between second and third dose is two months.
Final Dose (Third or Fourth):
Not to be administered to children <24 months old and to be given atleast 16 months after the first dose.
After the birth dose, in cases where a combination vaccine is given, a four dose regimen is recommended.
Catch-up schedule:
A 3 dose regimen is to be completed in unvaccinated children.
For 11-15 year old: Two doses at least four months apart containing adult formulation.
Adverse Effect :
Local reactions, fever, headache, vertigo, arthralgia, malaise, arthritis and erythema. Anaphylaxis is a rare presentation. Serious adverse effects include erythema multiforme, Guillain-Barre syndrome, Stevens Johnson syndrome, seizures, hypotension, alopecia and autoimmune disorders.
Interaction :
There are no known interactions with other vaccines.
Hepatic Dose :
No dosage adjustments are recommended.