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Vaccines Don't Save Lives, Vaccination Does
Published in Norman Begg, The Remarkable Story of Vaccines, 2023
There is inevitably a political element in vaccine policy. Some diseases attract more attention than others. Meningitis is relatively uncommon but very scary and headline worthy. Vaccination has an immediate impact on meningitis, and is likely to be more attractive from a government’s point of view than a chronic disease, like hepatitis B, where the long-term effects of the disease are only seen after many years. It takes twenty years to see the full impact of a hepatitis B vaccination programme; well beyond the lifespan of most governments. Health economists actually take this into account using something called discounting, where disease impact that occurs in the future has a lower monetary value than something that happens immediately. With the COVID-19 pandemic, health economics has taken a bit of a back seat. Governments have poured money into COVID-19 vaccines at an unprecedented rate. As the disease comes under control, health economics is starting to play a role in the deciding the frequency of boosters and whether to extend the vaccine to younger children.
Preconception Care
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Hepatitis B vaccination should be offered to all susceptible patients of reproductive age. This is especially true in regions with intermediate and high rates of endemicity (where ≥2% of the population is hepatitis B surface antigen [HBsAg] positive). Perinatal transmission of hepatitis B results in a 90% chance of chronic infection in the newborn, which places the child at risk for future cirrhosis and hepatocellular carcinoma. In regions of low prevalence, vaccination should be targeted to high-risk groups (Table 1.5).
Sexual and Gender-Based Violence
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Where travel medicine services are offered, people on the move should be offered hepatitis B vaccination prophylactically, not only because they are a group vulnerable to sexual violence, but because they may be travelling in harsh and crowded conditions where they are likely to come into contact with infected blood.
Duration of immunogenicity of high-dose and prolonged-schedule hepatitis B vaccine among patients with chronic kidney disease: A one year follow-up study in China
Published in Expert Review of Vaccines, 2022
Yujie Han, Na Cao, Xiaoxiao Lu, Tian Yao, Jing Shi, Yuanting Wu, Shuang Dong, Zhihong Shao, Jianmin Wang, Hongting Liu, Hongping Guo, Guowei Chai, Liming Liu, Fuzhen Wang, Yongliang Feng, Xiaofeng Liang, Suping Wang
Data from longitudinal studies of healthy adults after a standard vaccination regimen indicated that a decrease in the anti-HBs concentrations to less than 10 mIU/mL is not considered a loss of protection in these immunocompetent individuals due to the role of immunological memory [33]. Despite the waning concentration of anti-HBs, a full primary course of hepatitis B vaccine confers protection against acute clinical disease and chronic hepatitis B infection for long periods of time [33]. A previous study showed that the protective effect of anti-HBs in responders after hepatitis B vaccination generally lasts at least 30 years, which is why no follow-up of anti-HBs concentration is needed in a healthy population [20]. In contrast, in CKD patients, the cellular immune response may be impaired when the anti-HBs concentrations are less than 10 mIU/mL, resulting in insufficient protection from HBV infection [34]. Consequently, optimizing the immunization regimen to improve the duration of immunogenicity has become a priority and crucial strategy.
Immunogenicity and safety of 4 intramuscular standard-dose and high-dose hepatitis B vaccine in people living with HIV: a randomized, parallel-controlled trial
Published in Expert Review of Vaccines, 2022
Yongliang Feng, Zhuanzhuan Chen, Ruixue Xie, Tian Yao, Yuanting Wu, Feng Yang, Chenli Yuan, Xiaoyong Nie, Fuzhen Wang, Xiaofeng Liang, Suping Wang
Coinfection with HBV and HIV is common because of the shared modes of transmission. The hepatitis B vaccine is generally accepted as an essential part of preventing HBV infection among PLHIV. However, compared with healthy adults, PLHIV have lower seroconversion rate and faster decline of protective antibody (anti-HBs) after completion of routine vaccination schemes [11]. To determine the optimal regimen for hepatitis B vaccination, we explored the immunogenicity of the hepatitis B vaccine by increasing the dose (60 µg) and/or the number of vaccinations (four doses) in this study. To our knowledge, this study is the first randomized controlled trial to assess the immunogenicity of the IM60 × 4 and IM20 × 4 groups of hepatitis B vaccine regimens versus the IM20 × 3 group hepatitis B vaccine regimen in PLHIV.
Long-term durability of immunogenicity induced by standard and triple-dose hepatitis B vaccine in patients receiving methadone maintenance treatment
Published in Expert Review of Vaccines, 2020
Tian Yao, Yuanting Wu, Shuang Dong, Linying Gao, Shan Shi, Zhihong Shao, Lina Wu, Dan Feng, Jing Shi, Yawei Zhang, Yongliang Feng, Xiaofeng Liang, Suping Wang
Hepatitis B virus (HBV) infection is a major global health problem, with an estimated global prevalence of 3.5%. Worldwide, approximately 257 million people live with chronic HBV infection [1], a major contributing factor to liver cirrhosis and hepatocellular carcinoma (HCC) [2,3]. Use of the hepatitis B vaccine is an effective measure to prevent HBV infection [4]. China introduced the hepatitis B vaccine into routine immunization management as a comprehensive strategy in 1992. In response, the HBV prevalence rate in adults dropped from 9.8% in 1992 to 6.1% in 2016 [5,6]. However, the rate of HBV infection remains high in specific population groups, particularly in patients receiving methadone maintenance treatment (MMT) [7–11], a widely used alternative treatment for opioid dependence in drug users [12,13].