Hepa-B

Indications

Hepatitis B Vaccine is a recombinant vaccine used to protect against infection with the hepatitis B virus, which can cause long-term liver disease, cirrhosis and liver cancer. It is recommended for all infants (in Bangladesh it is given as part of the routine childhood immunisation schedule), and for children and adults who have not been vaccinated, especially health workers, people on dialysis, people with chronic liver disease or diabetes, family and sexual contacts of infected people, and newborns of mothers who carry the virus.

How It Works

The vaccine contains a purified surface protein of the hepatitis B virus (HBsAg), made in yeast cells. It contains no live virus and cannot cause hepatitis. The immune system learns to recognise this protein and makes protective antibodies, so if the person is later exposed to the real virus it is destroyed before it can cause infection.

Dosage and Administration

Given by a doctor, nurse or trained vaccinator as an injection into the muscle, usually the upper arm in adults and the thigh in infants. The dose (paediatric or adult strength) and schedule are set by the health professional or national programme. A common schedule is three doses at 0, 1 and 6 months; faster schedules are used for some groups, and people on dialysis may need higher doses. A birth dose may be given to newborns, especially of infected mothers, sometimes together with hepatitis B immunoglobulin.

Interactions

It can be given at the same visit as other vaccines, using a different injection site. Immunosuppressive treatment (such as chemotherapy, high-dose corticosteroids or transplant medicines) may reduce the response; antibody levels may be checked afterwards.

Contraindications

• Severe allergic reaction (anaphylaxis) to a previous dose or to any vaccine component, including yeast.
• Vaccination should be delayed during a moderate or severe illness with fever; a minor cold is not a reason to delay.

Side Effects

Common effects include pain, redness, swelling or a small lump at the injection site, mild fever, tiredness, headache, irritability in infants and mild nausea. These usually settle within 1 to 2 days.

Get urgent medical help if, usually within minutes to hours of vaccination, there is swelling of the face, lips or throat, difficulty breathing, widespread hives, faintness or collapse. Also seek medical advice for a high fever, a seizure, or unusual weakness or numbness.

Pregnancy and Lactation

The vaccine contains no live virus and may be given during pregnancy to women at risk of infection. It can be given while breastfeeding, and breastfeeding is safe for babies of vaccinated mothers.

Precautions and Warnings

The vaccinator will have treatment for allergic reactions ready, and you should wait about 15 to 30 minutes after the injection. People with bleeding disorders may need extra care at the injection site. Some people, such as those on dialysis or with weak immunity, respond poorly and may need antibody tests and extra doses. Keep a record of each dose and complete the full course.

Overdose

An extra dose is not expected to cause harm beyond usual injection-site reactions. Tell the health worker so the schedule can be checked.

Therapeutic Class

Vaccine, recombinant hepatitis B (inactivated, viral).

Storage

Store in a refrigerator at 2 to 8°C; do not freeze, and discard if frozen. Protect from light. Kept and given by health facilities.