Hepatitis B

PEDIATRIC ADVISOR: IMMUNIZATION - HEPATITIS B VACCINE
Your child has just been given an immunization to protect him/her against infection of the liver caused by the hepatitis B virus. The most common side efect is soreness where the shot was given. Apply a cool cloth 2-3 times a day. Older children should be encouraged to walk and excercise their legs. A fever may occur 1-2 days after the immunization.

Hepatitis B is a serious disease caused by virus (HBV). It can cause acute illness that may lead to chronic complications such as liver damage, liver cancer and death. Hepatitis B virus is spread through contact with the blood and body fluids of an infected person. Any person can be infected by having unprotected sex with infected person, by sharing needls when injecting drugs, during birth when virus passed from an infected mother to her baby, etc. Hepatitis B vaccine is a vaccine for the prevention of hepatitis B virus infection. The vaccine contains one of the viral proteins HbsAg. Afterward an immune system antibody HBsAg is established in the bloodstream. The antibody is known as anti-HBsAg. This antibody and immune system memory then provide immunity to hepatitis B infection. Subsequently it has been appreciated that long-term immunity derives from immunological memory which outlasts the loss of antibody levels and hence subsequent testing and administration of booster doses is not required.
Who should get hepatitis B vaccine and when?
In Czech republic get hepatitis B vaccine
1) Every child older than 12 weeks during regular vaccination in compound vaccine /1 injection for vaccination against Diphteria, Pertussis, Tetanus, Haemophilus influenzae B, Poliomyelitis and Hepatitis B/ in 3 doses series with at least 1 month long interval between these doses. One more shot should be applied at least 6 months after the 3rd dose, but before 18 months of age
2) Every 12 years old child who has not get HBV vaccine till this age in 3 doses series (a course of three vaccine injections are given with the second injection at least one month after the first dose and the third injection given six months after the first dose) or in rapide regime (1st dose now, 2nd dose 1 month after the dose 1, 3rd dose 2 months after dose 1, booster dose 12 months after dose 1)
3) Every newborn of HBV infected or HBsAg positive mother in 3 doses series with the 1st dose during first 24 hours of birth
4) Adults at the risk:
- people who have more than 1 sex partner in 6 months
- men who have sex with other men
- sex contact of infected people
- people who inject illegal drugs
- health care and public safety workers who might be exposed to infected blood or body fluids
- household contacts of person with chronic HBV infection
- haemodialysis patients
- patient who need repetitive transfusion of the blood
- patients with liver failure or before transplantation
- people who travel to countries where hepatitis B is common
- people with HIV infection
5)Anyone else who wants to be protected from HBV infection
If you are not sure wheather you are at risk, ask your doctor or nurse.
Hepatitis B vaccine may be given at the same time as other vaccines.

Who should not get hepatitis B vaccine?
- anyone who has allergy to any part of the vaccine
- anyone who has had life threathing allergic reaction to previous dose of hepatitis B vaccine should not get another dose
- anyone who is moderely or severely ill when a dose of vaccine is scheduled should wait untill he recover

Hepatitis B vaccine risks
Hepatitis B vaccine is very safe. Most people do not have any problem with it.
The following mild problems have been reported:
- soreness where the shot was given /about 1 person in 4/
- temperature of 100dgF /37,7dgC/ or higer /up to 1 person in 15/
Severe problems are extremely rare:
The vaccine like any medicine, could cause serious problems, such as severe allergic reaction. The risk of any vaccine causing serious harm, or death, is very extremely small.
Life-threathing allergic reaction from vaccines are very rare. If they occur, it would be within a few minutes to a few hours after the vaccination.

What if there is a severe reaction?
What should I look for?
Any unusual condition, such as a high fever or behavior changes. Signs of serious allergic reaction can include difficulty breathing, hoarsenes or wheezing, hives, paleness, weakness, a fast heart beat or dizzines.
What I should do?
- Call the doctor or get the person to the doctor.
- Tell your doctor, what happened, the date and time it happened, and when the vaccination was given

How can I learn more?
Ask your doctor or nurse.

What types of HBV vaccine are available in Czech republic?
- Engerix - B vaccine, against hepatitis B
- Twinrix adult or paediatric, against hepatitis B and A
- Infanrix HEXA against hepatitis B, diphteria, pertussis, tetanus, poliomyelitis and hemophillus influenzae B