Immunomodulatory Therapies
David E. Thurston, Ilona Pysz in Chemistry and Pharmacology of Anticancer Drugs, 2021
Following the success of the national hepatitis B vaccination program in Taiwan, administration of hepatitis B vaccination was recommended for all infants and children up to the age of 18 by the WHO and the US Centre for Disease Control and Prevention (CDC) in 2009. In the UK, it is now routinely given as part of the NHS vaccination schedule to babies aged 8, 12, and 16 weeks. In particular, individuals considered to be at an increased risk of hepatitis B include infants born to those who inject drugs, those who change sexual partners frequently, health care workers with occupations putting them at risk of contact with blood or bodily fluids, such as nurses and doctors, and those travelling to high-risk countries. Once vaccinated, the individual is protected for life.
General healthcare of drug users
Berry Beaumont, David Haslam in Care of Drug Users in General Practice, 2021
The standard immunisation schedule for administration of hepatitis B vaccine is to give doses at 0, 1 and 6 months. However, drug users may be peripatetic and are often homeless and in our practice we use an accelerated schedule of 0,1 and 2 months, giving the first dose of vaccine at the same time that blood is taken for hepatitis B markers and before the result of this is known. Even shorter schedules of 0, 7 and 21 days have been implemented elsewhere and have been shown to be acceptable to the homeless.16 If, after the third dose using the accelerated schedule, post-vaccination serology indicates successful seroconversion, a booster is given at 12 months. Non-responders (those who show no rise in hepatitis B surface antibody after a course of vaccine) may be treated by offering a further course immediately – some authorities recommend doubling the dose of vaccine. The immunological response to hepatitis B vaccination may be impaired in those who are HIV positive or otherwise immunocompromised or who are over 40 years of age.
Answers
Ken Addley in MCQs, MEQs and OSPEs in Occupational Medicine, 2023
The diseases and timeline are as follows: Hepatitis B: Hepatitis B vaccine is highly effective in preventing acute infection after exposure if given within seven days and preferably withing 48 hours. Hepatitis B immunoglobulin (HBIG) is only indicated where the source is known HBsAg Positive, or where the recipient is a known non responder to hepatitis B vaccine AND the source is known to be high risk. HBIG should ideally be given within 48 hours but not later than seven days after exposure.HIV: Post-exposure prophylaxis should be considered only if within 72 hours of the exposure.
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].
To boost or not to boost? The long-term protection of people vaccinated in infancy from the perspective of the healthcare worker
Published in Infectious Diseases, 2020
In contrary, Bruce et al. concluded, in the longest cohort study on extended protection after hepatitis B vaccination to date, that hepatitis B booster doses are not currently needed for children, adolescents and adults vaccinated (e.g. healthcare workers) at 30 years out from primary vaccine series [8]. Anderson et al. concluded that paediatric doses of hepatitis B vaccine offers long-term protection against hepatitis B in adolescents up to 15–16 years, and produces a robust ‘anamnestic response’ and robust immune memory, which prevents acute disease and chronic infection [9]. The data presented by Bruce et al. confirm statements from the World Health Organisation (WHO), Centres for Disease Control and Prevention (CDC), and Viral Hepatitis Prevention Board that booster vaccination against hepatitis B for immunocompetent children and adults is not recommended. The Cochrane Database Systemic Review from 2016 concluded that there is no scientific evidence to support or reject the need for booster doses of hepatitis B vaccine in healthy individuals with normal immune status [10].
Vogt-Koyanagi-Harada Disease Associated with Hepatitis B Vaccination
Published in Ocular Immunology and Inflammation, 2019
Arjun B. Sood, Ghazala O’Keefe, Diem Bui, Nieraj Jain
The hepatitis B vaccine is a single-antigen formulation that contains non-infectious material and can be administered in a series of two or three intramuscular doses.4 While uncommon, hepatitis B vaccine-associated uveitis has been previously reported.5,6 Fraunfelder et al. reported on 32 patients who developed uveitis an average of three days following hepatitis B vaccination.5 There was no comment on the location or type of uveitis; however, inflammation occurred after the first dose in 15 patients, after second dose in 3 patients and after third dose in 3 patients (data unknown for 9 patients). Two patients developed recurrent uveitis on re-challenge suggesting some causal relationship between the vaccine and development of uveitis.5 One case of VKH associated with the influenza vaccine has also been previously reported, although in this case the uveitis manifested one month following vaccination.6
Related Knowledge Centers
- Hepatitis B
- Hepatitis B Virus
- Immunosuppression
- Intramuscular Injection
- Preterm Birth
- Pregnancy
- Vaccine
- HIV/AIDS
- Hepatitis B Immune Globulin
- Breastfeeding