HEPATITIS B VACCINE

Type of vaccine
Killed, recombinant type

Route of administration
Intramuscular injection

Dose
0.5 mL till 10 years of age; adult dose: 1 mL

Diluent
None

Side effects
Soreness, erythema, induration, fatigue, fever, malaise, influenza-like symptoms.
Less common systemic reactions include nausea, vomiting, diarrhea, abdominal pain, abnormal liver function tests, arthralgia, myalgia, rash, pruritus and urticaria.website, insert

Contraindication
Known hypersensitivity to any component of the vaccine or subjects having shown signs of hypersensitivity after previous hepatitis B vaccine administration.
Neither pregnancy nor lactation is a contraindication to hepatitis B vaccination, if otherwise indicated.

Storage
Hepatitis B vaccine should be stored between +2°C and +8°C.
Not to be frozen. Discard if vaccine has been frozen.

Protective efficacy
98–99%

Protective duration
Long term, perhaps lifelong

Whether part of NIS?
Yes

Schedule under NIS:
At birth along with BCG and bOPV
(Pentavalent vaccine at 6, 10 and 14 weeks of age has replaced hepatitis B at these ages)

Site
• Anterolateral aspect (outer side) of LEFT mid-thigh in neonates and infants
• Deltoid region in adults and children

What is the “birth dose” of hepatitis B?
‘Birth dose’ of Hepatitis B is the dose given within 24 hours of birth. A child vaccinated with Hep B after more than 24 hours of birth is not considered to have received the ‘birth dose’.

Why is the birth dose of hepatitis B vaccine given only within 24 hours of birth?
The birth dose of hepatitis B vaccine is effective in preventing peri-natal transmission of hepatitis B only if given within the first 24 hours.

Why is hepatitis B vaccine given only till 1 year of age?
Hepatitis B vaccine is given till 1 year of age because infections during first year of age have a 90% chance of becoming chronic as against 30% during 1–5 years and 6% after 5 years of age.1

Indications other than routine immunization
• Health care personnel
• Persons with high-risk sexual behavior
• Patients receiving frequent blood products
• Injectable drug users
• Travelers to areas endemic to HBV
• Recipients of solid organ transplantation
• Infants born of mothers who are HBV carriers
• Household contacts of any of the above groups and of patients with acute or chronic HBV infection

Schedule for adults
• Rapid schedule with immunization at 0, 1, and 2 months will provide quicker protection.
• A longer schedule of 0, 1, and 6 months results in higher antibody titers.1, 3

Is it important to give vaccine of the same brand for different doses?
No, it is not essential to give vaccines of same brands only for all the doses. As far as hepatitis B vaccine is concerned, all brands are considered immunologically comparable and can be used interchangeably.

References:
1. GOI. Immunization Handbook for Medical Officers. New Delhi: Department of Health and Family Welfare; 2016.
2. Park K. Epidemiology of communicable diseases. In: Park's Textbook of Preventive and Social Medicine, 24th ed. Jabalpur, India: M/S BanarasidasBhanot Publishers; 2017.
3. PRODUCTS SUPPLIED IN INDIA. Serum Institute of India website. Available at: http://www.seruminstitute.com/product_overseas.php accessed on 1st November 2017

4. Central Drugs Standards Control Organization website. Available at: http://www.cdsco.nic.in/writereaddata/Serum%20Institute%20Hep_B.pdf accessed o 3rd November 2017

National Immunization Schedule in India; 2017: http://www.ihatepsm.com/blog/national-immunization-schedule-india-2017

Rotavirus vaccine: http://www.ihatepsm.com/blog/rotavirus-vaccine

Pentavalent vaccine: http://www.ihatepsm.com/blog/pentavalent-vaccine

BACILLE CALMETTE GUERIN (BCG) VACCINE: http://www.ihatepsm.com/blog/bacille-calmette-guerin-bcg-vaccine

IPV (INACTIVATED POLIOVIRUS VACCINE): http://www.ihatepsm.com/blog/ipv-inactivated-poliovirus-vaccine

DT & TT Vaccines: http://www.ihatepsm.com/blog/dpt-and-tt-vaccines

Oral Polio Vaccines (OPV): http://www.ihatepsm.com/blog/oral-polio-vaccines-opv

Measles Containing Vaccines (MCV): http://www.ihatepsm.com/blog/measles-containing-vaccines-mcv

HEPATITIS B VACCINE: http://www.ihatepsm.com/blog/hepatitis-b-vaccine

JAPANESE ENCEPHALITIS (JE) VACCINE: http://www.ihatepsm.com/blog/japanese-encephalitis-je-vaccine

Pneumococcal Conjugate Vaccine (PCV): http://www.ihatepsm.com/blog/pneumococcal-conjugate-vaccine-pcv