<h1>Hepatitis B Vaccine And Its Significance</h1>

Hepatitis B vaccine

Why hepatitis B virus is more dangerous than HIV?

Hepatitis B virus ( HBV) causes hepatitis (liver inflammation). This can lead to liver cirrhosis (small shrunken liver) and cancer.
HBV is transmitted very easily through blood, body fluids and this is an important cause of morbidity and mortality. It kills more people in the world per year than HIV. This can be easily transmitted from mother to baby at birth.

As HBV can survive adverse atmospheric conditions, this is a of more concern than HIV. This HBV is more dangerous than HIV as rapid death can occur within a few days due to “ fulminant liver (hepatic) failure”. Development of Hepatitis B vaccine proved to be a major milestone as it has helped in preventing deaths due to liver cirrhosis and cancer. Once fulminant liver (hepatic) failure develops, liver transplantation remains as a trial Rx which may help

Magnitude of the problem

More than 2 billion people worldwide have been infected with the virus and 600 000 persons die each year due to the complications of hepatitis B.

Dose Schedule

Doses are given at 0, 1 , 6 months. 0 means the day when 1st dose is given. Booster doses are recommended after every 5 year

Dosage

The standard adult dose is 1 ml.
The standard pediatric dose is 0.5 ml.

Market Preparations

It is available as

1. Genetically engineered vaccine ( engerix, shanvac)

2. Derived from human sera of infected people

Genetically engineered recombinant hepatitis B vaccine is preferable as it doesn’t have the risk of transmitting infection from 1 person to the other. Serum derived vaccines can transmit infection like HIV though this is very rare. Hepatitis-B surface Antigen (HBsAg) is produced in genetically engineered yeast cells of Pichia pastoris which carry the gene that codes for the major surface antigen protein of the hepatitis-B virus.
It is available with following brand names

1. Engerix

2. Shanvac

3. REVAC-Bmcf - This is free of Thiomersol (Mercury) and Cesium Chloride

Vaccine is available in single-dose and multi-dose vials.

Careful maintenance of the cold chain ( proper temperature while storage) is the most important precaution for all vaccines.

When Hepatitis B vaccine Is Recommended

1. All healthcare workers ( doctors, Pathology laboratory staff) who handle blood and blood products should get vaccinated. Many healthcare workers hav got infected and some of them have expired.

2. If a lady with active hepatitis B infection delivers a baby, baby has a risk of getting infection. In all such cases, Baby should be vaccinated within 48 hours of birth. Also we have to give hepatitis B immunoglobulins to baby.

How To Check Response to Vaccination?

Blood testing is recommended 1-4 after vaccination to determine antibody titres. If antibody levels are above 100 mIU/ml, its considered as satisfactory response. If levels are less, additional 1 dose is recommended.

Booster Dosage

After a lot of controversial reports, UK guidelines now suggest that for initial responders who require lifelong protection, such as for healthcare workers, only a single booster is recommended at 5 years.

Efficacy

It is 95% effective in preventing HBV infection.

How It Is Given?

HepB vaccine is given by intramuscular injection in the anterolateral aspect of the thigh (infants) or deltoid muscle (older children). It can safely be given at the same time as other vaccines, such as DTP,Hib, measles, OPV, BCG, and yellow fever vaccines. If more than one injection is given at the same time, separate injection sites should be used.

Risks and Complications associated with Vaccination

This is not common. Sometimes child may develop reaction in the form of fever, swelling, etc.at injection site.
Its a very safe vaccine. The only concern was an increased risk of multiple sclerosis. But now it has been proved that HBV vaccine doesn’t lead to an increased risk of multiple sclerosis.

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Vaccination Schedule for Child

Vaccination for baby - Protection against childhood Infectious diseases

Child's Vaccination
. One should take all precautions to prevent this disease.

1 Avoid unprotected intercourse with commercial sex workers.Use of condoms is recommended


2 Make it sure that all blood products have been checked for HIV before transfusion

3 Licencing & screening of commercial sex workers by Govt will be very helpful

4 Start sex education in schools after std 8th

5 Use disposable needles, blades.Proper sterilization of instruments in hospitals before surgery

6 Avoid sharing of needles in case of intravenous drug abusers