Hepatitis vaccines
What are the diseases caused by Hepatitis A ?
Hepatitis A virus causes infection of the liver, which may cause jaundice. An individual can get this infection through water or contaminated food or by close contact with a person infected with Hepatitis A.
Majority of children below 5 years of age will not have any symptoms when infected with this virus.
Older children may have mild symptoms like weakness, loss of appetite, fever, nausea, vomiting, pain in abdomen, dark yellow color urine and jaundice (yellowish discoloration of eyes, and skin).
Rarely, hepatitis A infection can lead to liver failure and death. Older children and adults have more severe disease.
Till few years back, more than 90% of children acquired Hepatitis A infection by 10 years of age. With improvements in hygiene and sanitation, children become more susceptible to infections at a later age, when the infection causes more severe disease, with some rare complications.
Apart from maintaining good hygiene and sanitation, vaccination of susceptible children and adults is the most effective way to prevent this disease.
What are the vaccines available against Hepatitis A and the schedules?
Two types of vaccines are available:
1. Inactivated (killed) vaccine
2. Live vaccine, which consists of the weakened Hepatitis A virus..
Minimum age of administration of this vaccine is 12 months.
The inactivated vaccine is administered in a two-dose schedule with the second dose administered at least 6 months after the first dose.
The live, weakened vaccine, is administered as a single dose after the age of 12 months.
Is it a safe vaccine?
Adverse reactions are minor and may include local pain and swelling and low grade fever.
Who should receive this vaccine?
All children > 12 months of age should receive this vaccine.
Who should not receive this vaccine?
Any child who has had a life-threatening allergic reaction after a previous dose of hepatitis A vaccine, or has a severe allergy to any component of this vaccine. The live, weakened vaccine should not be given to persons with weak immune system
What is Hepatitis B Infection and disease?
Hepatitis B virus causes carrier state without any symptoms, acute jaundice (infection of liver), chronic progressive liver damage and cancer of the liver. In India, 1.6% to 4% of the population carry this virus in their blood.
This virus has many ways of spreading from one to another:
1. From the infected mother to the newborn. This is the most common mode of spread and without appropriate preventive measures, a good number of infected infants go on to develop liver disease and liver cancers. This is called “Vertical transmission” and is eminently preventable with timely vaccination, beginning in the newborn period.
2. From infected family members or close contacts by sharing of articles like toothbrushes and razors
3. By sexual spread from an infected partner.
By using Hepatitis B vaccine appropriately, Hepatitis B infection can be prevented very effectively.
What is the schedule of the Hepatitis B vaccine?
1. The 1 dose is administered within 24 hours of birth as a single component vaccine.
2. The 2 and subsequent doses are administered at 6-10-14 weeks in combination with DPT/Hib/IPV
3. For older children and adults, the vaccine is administered in a schedule of 0-1 month –6 months.
There is no need for booster doses of this vaccine as the initial 3-4 doses confer almost life-long protection
What is the schedule for babies who are born to mothers who are infected with the Hepatitis B virus?
For babies born to mothers who are positive for the Hepatitis B virus in their blood, it is essential that the newborn receive a special injection known as the Hepatitis B Immunoglobulin (HBIG) as soon as possible after birth along with the regular schedule of the vaccine as mentioned above. This schedule is ~ 95% effective in preventing the transmission of the virus to the newborn.
Is it a safe vaccine?
Yes, except for some reactions at the site of vaccination and low-grade fever, the vaccine is safe
Who should receive this vaccine?
All infants and children should receive this vaccine
Who should not receive this vaccine?
Children who had a severe allergic reaction like anaphylaxis, after a previous vaccine dose, or have any known severe, life threatening allergies to any vaccine component