If I Had the Hep a Vaccine Can I Take It Again

Over the past xv years, the use of hepatitis A and B vaccines as recommended by the Advisory Commission on Immunization Practices (ACIP) has resulted in a substantial reduction of cases of both types of viral hepatitis. In the The states, an estimated 850,000-2.ii million individuals are chronically infected with the hepatitis B virus and each yr, approximately 30,000-50,000 cases of hepatitis A occur. New cases of hepatitis B infection in the US had been decreasing until recently; however, in recent years, acute cases of hepatitis B have increased and there accept been several outbreaks of hepatitis A.

This past year, two further concerns became evident: one) under the influence of the national epidemic of opioid abuse, rates of hepatitis B in middle-aged adults actually started to rise and 2) outbreaks of hepatitis A have occurred in several Us cities, often among homeless populations.

To help address the challenges surrounding hepatitis A and B in the United states, the National Foundation for Infectious Diseases (NFID) hosted a webinar* in Oct 2017 and later adult responses to frequently asked questions:

Hepatitis A


What is the recommended treatment for acute hepatitis A virus?
Unvaccinated individuals who take been exposed recently (within two weeks) to hepatitis A virus (HAV) should become hepatitis A vaccine or immune globulin to prevent severe illness. There is no specific handling for hepatitis A. Supportive care, such as fluids, nutrition, and remainder, is also recommended.

How strict is the recommendation to administrate the end dose of hepatitis A vaccine at vi months? Are there data to support administering a tertiary dose if the 2nd dose is administered within 6 months of the 1st dose?
A decreased immune response may occur when doses are administered earlier than the recommended interval. Doses of whatsoever vaccine administered ≥5 days earlier than the minimum interval or historic period should non be counted as valid doses and should be repeated as historic period appropriate. The repeat dose should exist spaced after the invalid dose by the recommended minimum interval. For example, if the start and 2d doses of hepatitis A vaccine were administered less than half dozen months apart, the 2nd dose is invalid and should be repeated at least 6 months after the invalid 2d dose.

Is there a take chances of reactivation of hepatitis A post-infection?
Reinfection of hepatitis A does not occur. Protective antibodies (IgG) develop in response to HAV infection and confer lifelong amnesty. However, relapsing hepatitis A has been described as an singular complication of hepatitis A virus infection.

Are there any current issues with hepatitis A vaccine supply on a national footing?
Yes, equally of November 2017, in light of ongoing outbreaks of hepatitis A amid adults in several Us cities, the demand for adult hepatitis A vaccine has increased substantially over the past half-dozen months and vaccine supply to meet this unexpected demand in the US has become constrained. The Centers for Disease Command and Prevention (CDC) website provides data on vaccine supply and shortages. Note that current constraints do not utilise to the pediatric hepatitis A vaccine supply.

Hepatitis B

Why should infants be vaccinated against hepatitis B?
Approximately 90% of infants who are infected with hepatitis B develop chronic hepatitis B infection and nigh 1 out of 4 infected babies will dice of liver failure or liver cancer as adults. All infants should be vaccinated in the national effort to completely eliminate mother-to-infant transmission of hepatitis B.

What is the recommendation on boosters and titers with hepatitis B for healthcare professionals?
Healthcare professionals (HCPs) who may come into contact with blood or trunk fluids during their work should be educated and offered vaccination confronting hepatitis B. Anti-HBs testing should exist performed 1-2 months after administration of the last dose of the vaccine series. Completely vaccinated HCPs with anti-HBs <10 mIU/mL should receive an additional dose of hepatitis B vaccine, followed by anti-HBs testing 1-2 months later. HCPs whose anti-HBs remains <10 mIU/mL should consummate the second series (usually 6 doses total), followed past repeat anti-HBs testing 1-2 months after the concluding dose. Alternatively, it might exist more than practical for very recently vaccinated HCPs with anti-HBs <10 mIU/mL to receive the second complete series (usually 6 doses full), followed by anti-HBs testing one-2 months after the terminal dose. CDC Guidance for Evaluating Health-Care Personnel for Hepatitis B Virus Protection and for Administering Postexposure Management contains boosted information. One time the vaccination and post-vaccination testing are complete, there are no recommendations for further periodic testing to assess anti-HBs levels and there are no recommendations for routine boosting with hepatitis B vaccine.

For medical workers/students who present without written evidence of hepatitis B vaccine serial, is the recommendation to titer or revaccinate (without a titer)?
HCPs defective documentation of hepatitis B vaccination should be considered unvaccinated (when documentation for hepatitis B vaccine doses is lacking) or incompletely vaccinated (when documentation for some hepatitis B vaccine doses is lacking) and should receive additional doses to consummate a documented 3-dose hepatitis B vaccine series.

Hepatitis (General)

Why are non-injection drug users at risk for hepatitis?
Individuals that fix and use not-injection drugs are typically in settings where they may accept lapses in personal hygiene which increases the likelihood of disease transmission via shared equipment, drugs, or close personal contact.

If a pediatric patient receives an developed dose of either hepatitis A or B, exercise they need to exist revaccinated?
No, notwithstanding if the vaccine series is not complete, that private should receive an age-appropriate dose at the adjacent recommended interval.

*NFID Webinar (CME/CNE): Hepatitis A and B Vaccines: Recommendations and Impact. Presented past Noele P. Nelson, Dr., PhD, MPH, Medical Officer in the Division of Viral Hepatitis at the Centers for Disease Control and Prevention (CDC). The webinar provides information on the immunogenicity and safety of hepatitis A and B vaccines, current ACIP recommendations, and the bear on of vaccine implementation on the changing epidemiology of hepatitis A and B diseases.

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Source: https://www.nfid.org/2017/12/19/9-frequently-asked-questions-about-hepatitis-a-b/