Hepatitis B vaccine

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Revision as of 17:56, 23 February 2021 by Aidan (talk | contribs)

Indications

  • Adults and children who have immigrated to Canada from areas where there is a high prevalence of HB.
  • Children born in Canada whose families have emigrated from areas where there is a high prevalence of HB and who may be exposed to HB carriers through their extended families or when visiting their family’s country of origin.
  • Children and workers in child care settings in which there is a child or worker who has acute HB or is a HB carrier.
  • Household and sexual contacts of acute HB cases and HB carriers.
  • Household or close contacts of children adopted from HB-endemic countries if the adopted child is HBsAg positive.
  • Populations or communities in which HB is highly endemic.
  • Residents and staff of institutions for the developmentally challenged.
  • Staff and inmates of correctional facilities.
  • People with lifestyle risks for infection, including:
    • persons who have unprotected sex with new partners
    • persons who have had more than one sexual partner in the previous 6 months
    • persons with a history of sexually transmitted infections
    • persons seeking evaluation or treatment for a sexually transmitted infection
    • persons who engage in high-risk sexual practices
    • persons who use injection drugs
    • men who have sex with men (MSM)
  • People with chronic liver disease from any cause, including those infected with hepatitis C. While these persons may not be at an increased risk of HB infection, they may be at risk of more severe disease if infection occurs.
  • Hemophiliacs and other people receiving repeated infusions of blood or blood products.
  • People with chronic renal disease, including those undergoing chronic dialysis (hemodialysis or peritoneal dialysis).
  • People with congenital immunodeficiencies.
  • People who have undergone hematopoietic stem cell transplantation (HSCT) or are awaiting solid organ transplant.
  • HIV-infected person.
  • Travellers to HB-endemic areas.
  • Health care workers, emergency service workers, and others with potential occupational exposure to blood, blood products and bodily fluids that may contain HB virus.
  • Any person who wishes to decrease their risk of HB.

Dosing

Post-Vaccine Serology

  • A cutoff of 10 IU/mL defines protective antibody titres
  • About 5% are primary non-responders and never had positive titres; they are not immune
  • However, their titres may have waned over time but they maintain the ability to mount an antibody response once exposed
  • Often need to revaccinate