Factors influencing the immune response to hepatitis B vaccine, booster dose guidelines, and vaccine protocol recommendations
Article Abstract:
The currently available vaccines against hepatitis B are effective in preventing acute disease, preventing the chronic carrier state, and preventing the transmission of virus. However, each year after immunization, the level of immunity declines three- to fourfold. Several factors affect the response of a person to hepatitis B virus (HBV) vaccination. Younger patients tend to respond better, and smaller patients respond better than heavier ones. Infection with the AIDS virus bodes ill for future hepatitis immunity; three published studies suggest that smokers do not respond as vigorously to HBV vaccine as do nonsmokers. The immunization protocol itself also affects the response; injections in the deltoid muscle (shoulder) are more effective than injections into the buttocks. Though there is evidence that intradermal injection into the deep layer of the skin is very effective and requires less vaccine, great care must be taken that the injection not be made into the upper layer of skin, where it may be ineffective. Higher doses of vaccine at frequent intervals enhance the immune response, and may be effective prophylaxis for those patients known to have been exposed. Although some low responders may require a booster inoculation after one or two years, some authorities recommend a booster five to seven years after the last vaccination. Since the immunized population in the United States has not exhibited clinically relevant disease, the Advisory Committee on Immunization Practices of the Centers for Disease Control has so far declined to make recommendations for booster schedules. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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Hepatitis B vaccination of neonates and children
Article Abstract:
Although the transmission of hepatitis B virus (HBV) from an acutely infected mother to the fetus is rare during the first trimester of pregnancy, the longer the gestation at the time of infection, the greater the risk of fetal transmission. In one published study, 24 women developed hepatitis B during their third trimester; 17 of their children had signs of HBV infection by their third month of life. The majority of such infants, however, do not develop acute symptoms, but rather become chronic carriers of the virus. Although some studies suggest that vaccine alone can prevent perinatal transmission of the virus, the recommended treatment for preventing the transmission of HBV to the newborn is the administration of hepatitis B immunoglobulins (antibodies), which confers immediate, temporary protection, and the HBV vaccine for the development of long-lasting active immunity. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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