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A brief overview of the vaccination of Hepatitis B for adults

The HBV vaccine is suggested for every child and infant up to the age of 18 years by the WHO (World Health Organization) as well as the CDC (US Centers for Disease Control & Prevention). Also, the CDC suggests that adults in the high-risk categories should maintain their hep b vaccine schedule. Every individual might be at a bit of risk for Hep B infection during his/her lifetime and that is why everyone should consider getting the Hep B vaccine. 

The vaccine for Hep B is an effective and safe vaccine that is suggested for every infant at birth as well as for kids up to 18 years. Also, it is recommended for those adults who live with diabetes along with the ones who have a high infection risk due to their lifestyle, jobs, country of their birth, or living situations. As everybody is at a bit of risk, they should consider getting vaccinated for lifetime security against the preventable chronic liver disease. This vaccine is also called the first “anti-cancer” vaccine since it averts Hepatitis B which is the major cause of liver cancer across the world. 

Don’t worry, you can’t get HBV from the vaccine. Every Hepatitis B vaccine which has been utilized since 1986 is synthetically made and it means that Hep B vaccines don’t contain any blood products. 

Child hep b vaccine schedule

Kids often get the Hep B vaccine as the series of 3 shots – 

  1. Soon after birth
  2. At 1-2 months of age
  3. At 6-18 months of age

Read Also: Hepatitis B: What are the symptoms and signs?

For their first shot – 

  • In case the mother of a newborn carries HBV in her blood, then the baby should get its vaccine under 12 hours after his/her birth. The kid also requires another shot i.e., HBIG (Hepatitis B Immune Globulin) for providing security against HBV right away. 
  • In case the mother of a newborn does not have this virus in her blood, then the baby can get the Hepatitis B vaccine under 24 hours after his/her birth. 

Anybody can get this vaccine series at any period in case they missed it in their childhood. This is particularly significant for those people who are at a higher infection risk. It includes public safety and health care workers, individuals suffering from HIV infection, those people who inject the drugs, and people with chronic kidney or liver disease. 

A few kids might be required to get vaccinated later in life, again and these include the ones –

  • Who require hemodialysis
  • Whose mothers have this virus into their blood
  • Whose immune system is weak

Engerix b dosing schedule

Engerix-B i.e., HBV vaccine (Recombinant) is the sterile suspension of the non-infectious HBV surface antigen (HBsAg) for the intramuscular administration. This consists of the purified surface antigen of HBV acquired by the culturing genetically arranged Saccharomyces Cerevisiae cells that carry your surface antigen gene of the HBV. 

Suggested Schedule and Dose

  • Individuals from birth through 19 years of age – Primary immunization for the infants (who are born of HBV surface antigen i.e., HBsAg-positive or HBsAg-negative mothers), adolescents (11 through 19 years of age), and children (since birth through 10 years of age) contains the 3 doses’ series (each 0.5 ML) given on the 0, 1, & 6-month schedule.  
  • Individuals aged 20 years and older – The primary immunization for individuals aged 20 years and older contains a series of 3 doses (1 ML each) given on the 0,1, & 6-month schedule. 
  • Adults on Hemodialysis – The primary immunization contains the series of four doses (each 2 ML) offered as the single 2 ML dose or 2 1ML doses on the 0,1,2, & 6-month schedule. When it comes to the Engerix b schedule for adults, in terms of the hemodialysis patients, the antibody response is lower as compared to the healthy individuals as well as protection might continue only as long as the levels of antibody stay over 10mlU/mL. Hence, the requirement for the booster doses must be evaluated by yearly antibody testing. The 2-mL booster dose (like the single 2-ml dose or 2 1mL dose) must be given while levels of antibody decrease below 10mlU/mL. 

Regular administration schedule for the HBV vaccine in the adults

  • The dosing schedule is 0, 1-2 months, as well as 4-6 months. 
  • There is a bit of flexibility in this schedule, however, consider the minimal intervals between the doses – 
  1. At least 4 weeks between 1st and 2nd dose
  2. At least 8 weeks between 2nd and 3rd dose
  3. At least 16 weeks between 1st and 3rd dose
  • In case the patient lags on his/her schedule of HBV vaccination (even if 1 year or more has passed), continue getting vaccinated from where the patient left off. Always remember that in this case, you do not have to restart your HBV vaccination schedule. 

There are groups which the CDC suggests must receive their Hep B vaccine, that includes – 

  • All kids who are 19 years old or more than that along with not having been previously vaccinated
  • Every infant, starting at birth
  • Sexually active individuals who are not in the mutually monogamous, long-term relation (for instance, more than 1 sex partner during the last 6 months)
  • Vulnerable sexual partners of Hep B positive individuals
  • Those men who indulge in any sexual activity with men
  • Individuals looking for treatment or evaluation for STD (Sexually Transmitted Disease)
  • Vulnerable household contacts of the Hep B-positive individuals
  • Any person using Injection drug 
  • People with an end-stage renal disease which includes hemodialysis, pre-dialysis, home dialysis, and peritoneal dialysis patients
  • Public safety and healthcare workers who are at risk for blood exposure
  • Staff and residents of facilities for the developmentally disabled people
  • People with chronic liver disease, except HBV (for instance fatty liver disease, Cirrhosis etc)
  • Travelers to as well as families adopting from those countries where this disease is common (like Africa, Asia, Pacific Islands, South America, Middle East, and Eastern Europe)
  • People suffering from HIV infection
  • Person with HCV (Hepatitis C Virus) infection
  • Every other individual looking for protection from Hep B virus infection i.e., acknowledgment of the particular risk factor is not the requirement for vaccination
  • Adults suffering from diabetes aged 19-59 years (it can be decided by clinicians whether or not to vaccinate the diabetic patients more than or at the 60 years)

Healthcare providers must execute standing orders for administering the HBV vaccine as a part of daily services to the adults who haven’t finished their vaccine series. Not only should they encourage people to follow their hep b vaccine schedule but they must also make the vaccination procedure a basic part of the assessment as well as treatment for HIV/AIDS and STIs. When possible, the Hepatitis B vaccine must be provided in the outreach along with another setting in which the services are offered to people at risk for this infection (for instance, HIV testing locations, needle-exchange plans, homeless shelters, and HIV prevention initiatives). 

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