If symptoms occur, they begin an average of 90 days range: 60— days after exposure to HBV 7 , 8. Symptoms typically last for several weeks but can persist for up to 6 months 7 , 8. Acute infection ranges from asymptomatic or mild disease to fulminant hepatitis, although the latter occurs only rarely.
The risk for chronic infection varies according to the age at infection and is greatest among young children. Three different serologic tests are needed hepatitis B surface antigen [HBsAg], hepatitis B surface antibody [anti-HBs], and total hepatitis B core antibody [anti-HBc] to determine whether a patient. About half of patients will no longer be infectious by 7 weeks after onset of symptoms, and all patients who do not remain chronically infected will be HBsAg-negative by 15 weeks after onset of symptoms 8.
CDC offers an online training that covers hepatitis B serology. People with acute infection are provided supportive treatment depending on their symptoms.
It is often accompanied by a flare in disease activity with elevation of liver enzymes with or without symptoms. HBV reactivation can be severe, resulting in death Others at risk include people. In certain health-care, evaluation, or treatment settings, a high proportion of clients have known risk factors for HBV infection.
ACIP recommends universal vaccination of adults who receive care in those settings, which include:. Three single-antigen vaccines and two combination vaccines are currently licensed in the United States. The vaccination schedule most often used for children and adults is three intramuscular injections, the second and third doses administered at 1 and 6 months, respectively, after the first dose. Child and Adolescent Immunization Schedules.
Anyone who has had a serious allergic reaction to a prior dose of hepatitis B vaccine, a component of the hepatitis B vaccine, or yeast should not receive hepatitis B vaccine. When hepatitis B vaccine is administered as part of a combination vaccine, contraindications to other vaccines should be checked. When feasible, vaccines from the same manufacturer should be used to complete the series, but vaccination should not be deferred when the manufacturer of the previously administered vaccine is unknown or when the vaccine from the same manufacturer is unavailable.
Different vaccination schedules apply for patients receiving vaccines from different manufacturers; details regarding how to complete the vaccination series using vaccine from a different manufacturer are available.
Data are limited on safety and immunogenicity when HepB-CpG is interchanged with HepB vaccines from other manufacturers If necessary, administering extra doses of single-antigen hepatitis B vaccine is not harmful. Administering hepatitis B vaccine at the same time as other vaccines has not been shown to interfere with antibody response.
Separate body sites and syringes should be used for simultaneous administration of injectable vaccines. The vaccine confers long-term protection against clinical illness and chronic hepatitis B virus infection. Cellular immunity appears to persist even though antibody levels might become low or decline below detectable levels Among vaccinated cohorts who initiated hepatitis B vaccination at birth, long-term follow-up studies are ongoing to determine the duration of vaccine-induced immunity ACIP recommends that all infants receive hepatitis B vaccine at birth, regardless of the infection status of the mother However, because errors or delays in testing, reporting, and documenting maternal HBsAg status can and do occur, administering the first dose of hepatitis B vaccine soon after birth to all infants acts as a safety net, reducing the risk for perinatal infection when maternal HBsAg status is either unknown or incorrectly documented at delivery.
The hepatitis B vaccine contains no live virus, so neither pregnancy nor lactation should be considered a contraindication to vaccination. Limited experience suggests that the developing fetus is at no apparent risk for adverse effects when hepatitis B vaccine is administered to pregnant women Meanwhile, new HBV infection in a pregnant woman might result in severe disease for the mother and chronic infection for the newborn.
Pregnant women who are identified as being at risk for HBV infection during pregnancy should be vaccinated and counseled concerning other methods to prevent HBV infection. Pregnant women may be at increased risk for hepatitis B if they. A pregnancy exposure registry external icon is a study that collects health information from women who take prescription medicines or vaccines when they are pregnant. A larger vaccine dose is required to induce protective antibody in hemodialysis patients, and larger or additional doses might also be necessary for other immunocompromised people.
Serologic testing of hemodialysis patients and other immunocompromised people is recommended 1—2 months after administration of the final dose of the primary vaccine series to determine the need for revaccination. Detailed guidance on vaccination of hemodialysis patients and other immunocompromised people is available from the Advisory Committee on Immunization Practices recommendations on adult hepatitis B vaccination pdf icon [40 pages].
After a person has been exposed to HBV, appropriate prophylaxis, given as soon as possible but preferably within 24 hours, can effectively prevent infection. The mainstay of postexposure immunoprophylaxis is hepatitis B vaccine, but, in certain circumstances, the addition of HBIG provides increased protection 20 , See Who should be screened for HBV?
The first vaccine dose should be administered immediately after collection of the blood sample for serologic testing. One of the limitations of our study was resistance to be part of the study as participation was voluntary. Another probable limitation was the lack of specific data on the vaccination history in the health cards of the study participants, but this was resolved by searching for information from other available data sources, so the effect of this limitation was reduced.
The present study showed the impact of the national universal infantile HBV vaccination program in Iran, and we demonstrated for the first time HBV vaccination effectiveness after 25 years of program implementation. According to our findings, Iran has successfully integrated the hepatitis B vaccine into routine immunization programs and has achieved a very significant effect on decreasing the HBsAg carrier rate among those born in and afterwards.
The rate of hepatitis B surface antigen decreased gradually from 3. In respect to better vaccination effectiveness and minimizing the disease prevalence in the country, catch-up hepatitis B vaccination programs for adolescents before high school entrance can provide immunity for the population. At this time, our data suggest that the addition of school-based programs to universal hepatitis B immunization of infants might be helpful for further decreasing HBV infection rate in our country and its consecutive complications.
We declare that there were no conflicts of interest in this study. Study participants were informed of the purpose, signed a written informed consent consent to participate was obtained from the participant themselves because their age range was between 17 and 49 years old and voluntarily enrolled in the study.
They were admitted to exercise confidentiality. The study protocol was approved and financially supported by Shiraz University of Medical Sciences, Fars province, Shiraz, Iran with the code Shiraz University of Medical Sciences funded the process of data collection, blood sampling, preparation of kits and laboratory tests. Analysis and interpretation of data and writing the manuscript were performed by the authors.
The study protocol has been approved and financially supported by Shiraz University of Medical Sciences, Fars province, Shiraz, Iran under the code The authors appreciate the collaboration of research and technology deputy of Shiraz University of Medical Sciences.
We thank the staff of the health system which provided the sera and laboratory staff at the health department in processing and testing the sera. The Brazilian Journal of Infectious Diseases. ISSN: See more Follow us:. Open Access Option. Previous article Next article. Issue 6. Pages November - December More article options. The effectiveness of the national hepatitis B vaccination program 25 years after its introduction in Iran: a historical cohort study.
Download PDF. Corresponding author. This item has received. Under a Creative Commons license. Article information. Table 1. Table 2.
Rates of hepatitis B markers before and after starting the hepatitis B vaccination program in Iran.. Table 3. Factors affecting HBV infection in vaccinated and unvaccinated cohorts.. Show more Show less. Objective To assess the effect of the national HBV mass vaccination program after 25 years. Methods A retrospective cohort study was conducted in vaccinated and unvaccinated people according to the year of birth.
Also, Vaccine effectiveness was measured by calculating the risk of disease among vaccinated and unvaccinated persons and defining the percentage risk reduction of infection in the vaccinated group.
Results A total of persons were interviewed. Conclusions Iran has successfully combined hepatitis B vaccination into regular immunization programs. With respect to vaccination effectiveness and low prevalence of the disease in the country, catch-up hepatitis B vaccination programs for adolescents can guarantee the immunity of the population.
Full Text. Introduction Hepatitis B virus HBV is responsible for one of the most critical human viral infections. Materials and methods Study Design: retrospective or historical cohort study for the evaluation of HBV vaccination impact. Study population and setting In the Islamic Republic of Iran, which has a population of 80 million, public health services are delivered through a nation-wide network.
Inclusion and exclusion criteria Inclusion criterion in the vaccinated group was the age of 17—24 years, and in the unvaccinated group it was the age range of 26—50 years.
Study sample The sample size calculation was based on an estimated incidence of HBV infection in the Iranian population according to the last Center of Disease Control data.
Immunization status An individualized investigation was conducted by trained staff. Fisher test. Lai, V. Ratziu, M. Yuen, T. Boccalini, C. Taddei, V. Ceccherini, et al. Economic analysis of the first 20 years of universal hepatitis B vaccination program in Italy: an a posteriori evaluation and forecast of future benefits. Hum Vaccin Immunother. Schweitzer, J. Horn, R. Mikolajczyk, G.
Krause, J. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between and Ott, G. Stevens, J. Groeger, S. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Cuervo, A. Comparison between in vitro potency tests for Cuban Hepatitis B vaccine: contribution to the standardization process.
Mast, H. Margolis, A. Fiore, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices ACIP part 1: immunization of infants, children, and adolescents.
Introduction of hepatitis B vaccine into childhood immunization services: Management guidelines, including information for health workers and parents. World Health Organization, ,. Mohaghegh Shelmani, P. Karayiannis, S. Ashtari, et al. Demographic changes of hepatitis B virus infection in Iran for the last two decades. Gastroenterology and hepatology from bed to bench. XXX, 10 , pp. Alizadeh, M.
Ranjbar, S. Ansari, et al. East Mediterr Health J. Merat, R. Malekzadeh, H. Rezvan, M. See Drug Reference for a full list of side effects. Drug Reference is not available in all systems. If you are exposed to HBV before you have received all three shots in the vaccination series, a dose of hepatitis B immune globulin HBIG usually will prevent infection until the vaccine takes effect. If you have already had hepatitis B and have developed protective antibodies to the virus, you do not need the vaccine because you have lifetime protection immunity against the infection.
If you are not sure whether you have had hepatitis B, you can be tested, or you can be vaccinated without testing. The vaccine is not harmful for you if you are already immune. If you have chronic HBV infection, the vaccine will be ineffective, although it is not harmful. The vaccine is safe for women who are pregnant or breastfeeding.
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Top of the page. How It Works The hepatitis B vaccine is given to protect people from getting the infection. All babies need three doses: The time between the first and second shot should be at least 1 month. The time between the second and third shots should be at least 2 months; ideally, it should be 4 months or more. Hepatitis B vaccination: the key towards elimination and eradication of hepatitis B.
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