| 1. | What is hepatitis B? | ||
Hepatitis B is a sexually transmitted disease caused by a virus (HBV) that attacks the liver. The virus is found in the blood and semen of infected men and is spread in the same manner as HIV. HBV is easier to catch than HIV because it is more than 100 times more concentrated in an infected person’s blood and can exist on surfaces outside the body | |||
| 2. | What Age Groups Are At Risk For Chronic Hepatitis? | ||
| •About 10% of adults, | |||
| •25-50% of young children (under 5 years) and | |||
| •70%-90% of infants infected with hepatitis B WHO are unable to clear the infection from their bodies in six months. | |||
| 3. | How is HBV spread? | ||
An HBV-infected man can spread the virus to another person by | |||
| •having unprotected anal or vaginal sex | |||
| •sharing needles for drugs, piercing, or tattooing | |||
| •coming in contact with the infected person’s open sores or blood | |||
| •sharing toothbrushes, razors, nail clippers, etc. | |||
| •biting another person | |||
| HBV can also be spread by living in a household with a chronically infected person. | |||
| 4. | What are the symptoms of hepatitis B? | ||
| The symptoms of the disease are extreme tiredness, nausea, fever, dark urine, bloated and tender belly, and yellowish-tinged skin and eyes. Infected persons can have no symptoms at all or be extremely ill. However, people who are infected with HBV can spread the disease to others, whether they have symptoms or not. | |||
| 5. | Do people fully recover from HBV infections? | ||
Most adults recover from HBV infection after several months and are no longer contagious. Unfortunately, about 2%-6% of adults who become infected with HBV will carry the virus in their bodies for years and remain infectious. Chronically infected people usually do not have symptoms, but are at increased risk for eventual liver failure (cirrhosis) and liver cancer and need ongoing medical care. There are about 43-45 million carriers in India. | |||
| 6. | How serious are HBV infections? | ||
HBV infection can cause serious liver disease, including liver failure and liver cancer and finally lead to death. | |||
| 7. | How can we prevent HBV infection? | ||
| •Avoid sharing needles and syringes with others. | |||
| •Avoid sharing razors and toothbrushes with infected people | |||
| •Use a condom during sexual intercourse. | |||
| •Vaccination is very effective against type B hepatitis, is available. | |||
| 8. | What are the vaccines available? | ||
There are two varieties of vaccines | |||
| 1.Plasma derived: that is obtained from purified plasma (rarely used) | |||
| 2.Recombinant vaccine: obtained by recombinant DNA technology which are the most widely used. | |||
| 9. | How many shots are needed to be protected against HBV infection and what is the schedule? | ||
The hepatitis B vaccine series consists of three doses with each dose given in a months gap. | |||
| Schedule in infants | |||
| Hepatitis B vaccine schedules are very flexible. There are various options for adding the vaccine to established national immunization schedules without requiring additional visits for vaccination (table 1). | |||
| Options for adding hepatitis B vaccine to childhood immunization schedules | |||
| Age EPI visit Antigens given at same visit No birth dose With birth dose Option 1 Option 2 Option 3 Birth 1 OPV1, DTP1, Hib1 HepB-birth (m) HepB-birth (m) 6 weeks 1 OPV1, DTP1, Hib1 HepB1(m/c) DTP-HepB1(c) 10 weeks 2 OPV2, DTP2, Hib2 HepB2 (m/c) HepB2 (m) DTP-HepB2 (c) 14 weeks 3 OPV3, DTP3, Hib3 HepB3 (m/c) HepB3 (m) DTP-HepB3 (c) 9–12 months 4 Measles Measles Measles Measles | |||
| 10. | Are these shots safe? Do they have any side effects? | ||
Hepatitis B vaccines have been proven to be safe. Globally, more than one billion hepatitis B vaccine doses have been given. Side effects might include soreness at the injection site, headache, and fatigue. | |||
| 11. | Are these shots effective? | ||
Yes. After three doses of hepatitis B vaccine, at least 90% to 95% of healthy young adults develop immunity to HBV infection. Immune compromised people might not respond as well to hepatitis B vaccine. They should be tested 1-2 months after the third dose of vaccine to see if they responded. | |||
| 12. | Will hepatitis A or hepatitis B vaccine protect me from hepatitis C? | ||
No. Hepatitis A, B, and C are all different viruses. The hepatitis C virus is spread through body fluids, and although it can be transmitted through sexual contact, it is most commonly acquired through injection drug use. Unfortunately, there is no hepatitis C vaccine at this time. | |||
| 13. | Are these shots recommended for travelers? | ||
Both HAV and HBV infection are common in many parts of the world. People traveling to any area of the world except the United States, Canada, Western Europe, Japan, New Zealand, and Australia should get vaccinated against HAV. Hepatitis B vaccine is recommended for many travelers also. Discuss this with your doctor. | |||
| 14. | Where can I receive these shots? | ||
Talk to your health care professional or your local public health department. | |||
| 15. | Who should get vaccinated? | ||
| •All babies, at birth | |||
| •All children 0-18 years of age who have not been vaccinated | |||
| •People of any age whose behavior or job puts them at high risk for HBV infection (see risk factors under general information) | |||
| 16. | Can you receive one dose of hepatitis B vaccine from one manufacturer and the other doses from another manufacturer? | ||
Yes. The immune response when one or two doses of a vaccine produced by one manufacturer are followed by subsequent doses from a different manufacturer has been shown to be comparable with that resulting from a full course of vaccination from one manufacturer. | |||
| 17. | What should be done if there is an interruption between doses of hepatitis B vaccine? | ||
If the vaccination series is interrupted 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 2 months. If only the third dose is delayed, it should be administered when convenient. | |||
| 18. | Can other vaccines be given at the same time that hepatitis B vaccine is given? | ||
Yes. When hepatitis B vaccine has been administered at the same time as other vaccines, no interference with the antibody response of the other vaccines has been demonstrated. | |||
| 19. | How long does hepatitis B vaccine protect you? | ||
Long-term studies of healthy adults and children, who have developed adequate antibody to hepatitis B surface antigen (anti-HBs), indicate that immunologic memory remains intact for at least 15 years and confers protection against clinical illness and chronic HBV infection, even though anti-HBs levels might become low or decline below detectable levels. | |||
| 20. | Can hepatitis B vaccine be given after exposure to HBV? | ||
Yes. After a person has been exposed to HBV, appropriate treatment, given in an appropriate time frame, can effectively prevent infection. The mainstay of post exposure immunoprophylaxis is hepatitis B vaccine, but in some settings the addition of HBIG will provide some increase in protection | |||
| 21. | Who should get post-vaccination testing? | ||
Testing for immunity is advised only for persons whose subsequent clinical management depends on knowledge of their immune status (e.g., infants born to HBsAg-positive mothers, immune compromised persons, healthcare workers, and sex partners of persons with chronic HBV infection). | |||
| 22. | When should post-vaccination testing be done? | ||
When necessary, post-vaccination testing, using the anti-HBs test, should be performed 1 to 2 months after completion of the vaccine series – EXCEPT for post-vaccination testing of infants born to HBsAg-positive mothers. Testing of these infants should be performed 3 to 9 months after the completion of the vaccination series | |||
| 23. | Are booster doses of hepatitis B vaccine needed routinely? | ||
No, booster doses of hepatitis B vaccine are not recommended routinely for persons who are not immune compromised. Data show that vaccine-induced anti-HBs levels might decline over time; however, immune memory remains intact indefinitely following immunization. Immune competent people with declining antibody levels are still protected against clinical illness and chronic disease. | |||
| 24. | Can hepatitis B vaccine be given to immune compromised people? (e.g., people on hemodialysis or people with AIDS) | ||
Yes, however larger vaccine doses or an increased number of doses are required to induce protective antibody in a high proportion of hemodialysis patients and might also be necessary for other immune compromised people (e.g., those who take immunosuppressive drugs or who have AIDS). For immune compromised people, it is important that post vaccination testing, using the anti-HBs test, be done 1-2 months after the last dose of vaccine to check that the vaccine worked. In addition, immune compromised people need periodic testing and possibly booster doses of hepatitis B vaccine to assure that anti-HBs is still adequate. | |||
| 25. | Who should not receive the vaccine? | ||
A serious allergic reaction to a prior dose of hepatitis B vaccine or a vaccine component is a contraindication to further doses of hepatitis b vaccine. The recombinant vaccine, Shanvac-B is synthesized using Pischia pastoris (yeast), into which a plasmid containing the gene for HBsAg has been inserted. Purified HBsAg is obtained by lysing the yeast cells and separating HBsAg from the yeast components by biochemical and biophysical techniques. Persons allergic to yeast should not be vaccinated with vaccines containing yeast. | |||
| Other relevant links | |||
| Information bank; Useful facts, figures and safety of commonly used vaccines V&B documents available on the internet National Centre for Infectious Diseases; Home page for Viral Hepatitis WHO Fact Sheet on Hepatitis B Viral Hepatitis Prevention Board; Home page International Travel and Health; Vaccination Requirements and Health Advice www.HepatitisB.org |