FACTS OF HEP-B VACCINES

[Drsumitra]

 

Questions & Answers

When did hepatitis B vaccine become available?
The first hepatitis B vaccine became commercially available in the United States in 1982. In 1986, a hepatitis B vaccine produced by recombinant DNA technology was licensed, and a second recombinant-type hepatitis B vaccine was licensed in 1989. The two recombinant DNA vaccines (Recombivax HB and Engerix-B) are the only hepatitis B vaccine preparations currently used in the United States. (There are additional products licensed in the U.S. that contain these vaccines in combination with other vaccines.)

Who should get this vaccine?
Hepatitis B vaccine, usually a three-dose series, is recommended for all children 0-18 years of age. It is recommended for infants beginning at birth in the hospital. All older children who did not get all the recommended doses of hepatitis B vaccine as an infant should complete their vaccine series as soon as possible. Most states require hepatitis B vaccine for school entry. Adolescents who are just starting their series will need two or three doses, depending on their age and the brand of vaccine used. Adults at increased risk of acquiring HBV infection should also be vaccinated. In addition, the vaccine can be given to any person who desires protection from hepatitis B.

Who is at increased risk of HBV infection?
Healthcare workers and public safety workers with reasonably anticipated risk for exposure to blood or blood-contaminated body fluids
Men who have sex with men
Sexually active people who are not in long-term, mutually monogamous relationships
People seeking evaluation or treatment for a sexually transmitted disease
Current or recent injection drug users
Inmates of long-term correctional facilities
People with end-stage kidney disease, including predialysis, hemodialysis, peritoneal dialysis, and home dialysis patients
Staff and residents of institutions or group homes for the developmentally challenged
Household members and sex partners of people with chronic HBV infection
Susceptible (non-infected and non-vaccinated) people from United States populations known to previously or currently have high rates of childhood HBV infection, including Alaska Natives, Pacific Islanders, and immigrants or refugees from countries with intermediate or high rates of chronic HBV infection. To see a list of these countries, go to wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/hepatitis-b.aspx
International travelers to regions with high or intermediate rates of HBV infection. To see a list of these countries, go to wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/hepatitis-b.aspx
In addition, any adult who wishes to be protected from HBV infection should be vaccinated (without having to acknowledge a specific risk factor).

Who recommends this vaccine?
The Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), and American College of Obstetricians and Gynecologists (ACOG) recommend this vaccine.

Is hepatitis B vaccine safe?
Yes. Hepatitis B vaccines have been demonstrated to be safe when administered to infants, children, adolescents, and adults. Since 1982, more than an estimated 70 million adolescents and adults and more than 50 million infants and children have received at least one dose of hepatitis B vaccine in the United States. The majority of children who receive this vaccine have no side effects. Serious reactions are rare.

What side effects have been reported with this vaccine?
Of those children experiencing a side effect, most will have only a very mild reaction, such as soreness at the injection site (fewer than one out of three children) or low-grade fever. Adults are slightly more likely to experience such mild symptoms. Serious allergic reactions following hepatitis B vaccination are rare.

How effective is this vaccine?
After three properly administered doses of vaccine, at least 9 out of 10 healthy young adults and more than 9 out of 10 infants, children, and adolescents develop protective antibodies and subsequent immunity to HBV infection.

Why is this vaccine recommended for all babies when most of them won’t be exposed to HBV for many years, if then?
There are four reasons for recommending that all infants receive hepatitis B vaccine, starting at birth. First, people have a very high risk for developing chronic HBV infection if they become infected at birth or during childhood, with an increased risk of dying prematurely from liver cancer or cirrhosis. In addition, HBV infection in infants and young children usually produces no symptoms, so these individuals can spread the infection to others without knowing it.

Third, most early childhood spread of HBV occurs in households where a person has chronic HBV infection, but the spread of HBV has also been recognized in daycare centers and schools.

Fourth, long-term protection following infant vaccination is expected to last for decades and will ultimately protect against acquiring infection at any age.

Should I be tested before I get the vaccine to see if I’m already infected or immune?
Blood testing before vaccination is not recommended for the routine vaccination of infants, children, and adolescents. However, children born in countries where HBV is moderate or highly endemic should be tested to be sure they are not already infected.

Testing can be done at the same visit when the first dose of hepatitis B vaccine is given. Vaccinating a person already immune to or infected with HBV will not help or harm the person. The main reason for testing people at increased risk for HBV is to determine if they are infected in order to refer them for medical care.

Should I get my blood tested after getting the vaccine series to make sure it worked?
Testing after vaccination is not recommended routinely. Testing after vaccination is recommended only for people whose medical care depends on knowledge of their response to the vaccine. This includes infants born to HBV-infected mothers; healthcare and public safety workers at risk of continued exposure to blood on the job; immune-compromised people (e.g., people with AIDS or on hemodialysis); and sex and needle-sharing partners of people with chronic HBV infection.

Who should NOT receive hepatitis B vaccine?
People who had a serious allergic reaction to one dose of hepatitis B vaccine should not have another dose of hepatitis B vaccine. People with a history of hypersensitivity to yeast should not receive this vaccine. People with a moderate or severe acute illness should postpone receiving the vaccine until their condition is improved.

Can I get this vaccine when I am pregnant?
Yes.

I’m an adult who wants hepatitis B vaccination. How can I pay for the shots?
If you have insurance, the cost of hepatitis B vaccination might be covered. If not, these shots are often available at low cost through special programs or from health departments. Call your local health department for details.

Will hepatitis B vaccination protect me from hepatitis A or hepatitis C?
No. Hepatitis A and hepatitis C are different diseases caused by different viruses. There is a vaccine for hepatitis A, but there is no vaccine for hepatitis C at this time.

 

        

[Drsumitra]

Hepatitis B virus (HBV) is a bloodborne virus of major concern in dental infection control. HBV transmission in a dental health care setting is rare, particularly since standard precautions and routine vaccinations for dental workers were adopted (1985 and 1987, respectively). There have been no reported transmissions from a dental worker to a patient since 1987.

A Journal of Infectious Diseases article describes a patient-to-patient transmission of HBV in a dental setting. The event occurred in 2001, when a person with acute hepatitis B was reported to a state health department. The state health department’s epidemiologic investigation found that the patient had none of the traditional hepatitis B risk factors, but reported having recent oral surgery. An investigation of the oral surgery practice where the patient received dental treatment revealed that another surgical patient seen earlier on that same day was on the state’s reportable disease registry for HBV. Molecular epidemiologic techniques indicated transmission of HBV between the two patients.

When investigators later visited the office and monitored its operation, they found that the office followed standard infection control practices, and that all staff had been previously vaccinated and were negative for HBV. The investigators could only speculate that a lapse in cleanup procedures had occurred after the source patient, leaving an area contaminated with blood.Hepatitis B virus (HBV) infection is considered an occupational risk for dental professionals. The Centers for Disease Control have participated in eight investigations regarding dental professionals who were suspected of transmitting HBV infection to their patients. This article summarizes the findings of the investigations, the postulated mechanism of transmission of HBV, control measures suggested, and follow-up of the dental practice for those dentists who were chronic carriers of hepatitis B surface antigen. The approach by the centers for managing dental professionals who are HBsAg positive and those dental professionals who are HBsAg positive and implicated as transmitting HBV infection to patients are outlined. If HBV transmission cannot be interrupted, by suggested measures, then more restrictive measures should be decided on by state or local health officials, or both. These could include removal of the practitioner’s license. HBV-infected dental personnel can transmit HBV infection to their patients. The measures suggested for the HBV carrier are designed to allow the dental practitioner to continue practice, but, at the same time, give maximum protection to the patient.

 

        

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