What you need to know about hepatitis B vaccination
Hepatitis B - is a contagious liver disease caused by a virus of the same name. Unfortunately, this is a viral liver disease - one of the most frequent and widespread.
Worldwide, the number of people infected with the virusHepatitis B is more than 2.1 billion. At the same time every year from acute and chronic hepatitis B kills about 1 million people. However, the disease is dangerous not only because of its prevalence and the large number of deaths, but also a significant number of disabled people among recover. Up to 10% of adults and up to 50-90% of children with acute hepatitis B virus carriers are, they have the infection becomes chronic with high risk of cancer and liver cirrhosis. The virus of hepatitis B, according to the World Health Organisation (WHO), is the major causative agent of primary liver cancer - 80% of all cases.
The source of the hepatitis B virus is a humanacute or chronic form of the disease or virus carrier (which infection in the body for a certain time not manifest itself). In popular literature, hepatitis B is often referred to as parenteral hepatitis (from the Greek: para - a departure from the usual + Entera - intestines) - thus emphasizing that an infectious agent enters the body, bypassing the digestive tract. It is generally known that hepatitis B virus infection is due to the administration to humans of products manufactured from the blood of infected people. However, this infection can enter the body through even the slightest scratch, abrasion if they accidentally become contaminated, for example, saliva, which contains a pathogen. The highest risk of infection arises in close household contact with patients or virus carriers (cohabitation, a visit to one group or class, a long stay in a hospital room, sharing personal hygiene). Since the causative agent of hepatitis B shed in semen and vaginal secretions, and the possible sexual way of infection, if one partner is infected or ill. In addition, infection can occur through contaminated medical and beauty tool, if it is not well sterilized.
We should also note addict transmission path when the drug is used for the introduction of syringes and needles have been in use among the infected.
Of particular note is a vertical pathinfection, ie, transmission of the virus from mother to her unborn child in utero or during birth. This occurs if the expectant mother carries the disease during pregnancy or is infected with HIV. The risk of transmission in this case may reach 90%.
Basic vaccination scheme
In the fight against viral hepatitis B, the primary roleassigned active specific immunization - vaccination against hepatitis B, which Russia introduced to the National immunization schedule and fixed by law.
There are several schemes of vaccination against this virus, consisting of the introduction of 3 or 4 doses of vaccines (for such schemes, and instill in our country).
Under normal circumstances the vaccination course consists of three vaccinations (according to the scheme 0-1-6):
1st inoculation (first dose) is inserted in the so-called day 0 (the first 12 hours of life).
2nd vaccination (second dose of the vaccine) is administered 1 month after the first.
3rd vaccine (third dose of the vaccine) administered 6 months after the first vaccination (ie, when the baby turns six months).
To create a full immunity should beadhere to the recommended timing of administration of the vaccine. Then the effective immunity against hepatitis B is formed not less than 95% of vaccinees. However, in some cases (the child's illness, change of residence, lack of vaccine) vaccination schedule is disrupted. At the same time we must remember that the interval between the first and second dose of the vaccine should not exceed 2-3 months, and the introduction of the third vaccination should be no later than 12-18 months from the start of vaccination.
To fast protection
If you want to speed up the production of anti-virus, use an alternate immunization scheme. At the same vaccination course consists of 4 vaccinations (0-1-2-12 scheme):
1st inoculation (first dose) is administered, the so-called day 0 (in the first 12 hours of life).
2nd vaccination (second dose of the vaccine) is administered 1 month after the first.
3rd vaccine (third dose of the vaccine) is administered 2 months after the first vaccination (ie, when the child is 2 months).
4th vaccination (fourth dose of the vaccine) is administered 12 months after the first vaccination (ie, when the baby turns 1 year).
This scheme is shown when the vaccination of childrenrisk groups (infants from the virus carrier mothers to mothers undergoing hepatitis B at the end of pregnancy, not vaccinated before the children and babies, who had contact with patients), as well as in cases when unvaccinated people need to speed up the immunity generation (for example, if there has been a transfusion infected blood).
In the latter case, to increase the immunologicalthe protection it is advisable to use the passive-active immunization, ie the first dose of vaccination (active immunization) be administered simultaneously using specific immunoglobulin (passive immunization). Specific immunoglobulin contains antibodies to influenza virus B and immediately after administration prevents the development of infection and a vaccine leads to delayed development of its own antibodies, which protect the body in the future.
Who is required to instill
Of course, newborns and infants. Their vaccination due to the fact that the infant carried in hepatitis B acquires 90% of chronic and associated with a high risk of developing cirrhosis and liver cancer.
When mass vaccine prophylaxis in the countrya high level of virus is just beginning, mandatory vaccination is necessary and adolescents. It is in this age group is high potential risk of hepatitis B infection due to sexual activity and drug use. Due to the fact that in Russia the average level of virus infection is 2-4%, and in some regions up to 5-7%, routine hepatitis B vaccine prophylaxis is carried out, and in infants and in previously unvaccinated adolescents.
According to the National calendarvaccinations, adopted in 2002, Russia hepatitis B vaccine can be combined with vaccines against other infections. For example, the third hepatitis B vaccination scheme 0-1-6 in 6 months of age is introduced simultaneously with the vaccine against whooping cough, diphtheria, tetanus (DPT) and polio vaccine (drops in the mouth). Children born to mothers-carriers of the virus or been ill with hepatitis B in the last trimester of pregnancy, are vaccinated according to the scheme 0-1-2-12 and fourth vaccination against hepatitis B (aged 12 months), combined with the planned vaccination against measles, rubella and mumps.
If vaccination is not done in the hospital
In some cases, enter into the first vaccine dosethe first 12 hours of life can not be as health. Contraindications are low birth weight (less than 1500g), expressed manifestations of intrauterine infection, birth asphyxia (suffocation), severe disorders of the various organ systems (kidney, respiratory, circulatory, central nervous system). In these cases, vaccination is carried out after stabilizing the condition of the child, and in extremely premature and small babies are not earlier than the second month of life. But if on the severity of the child status can not be vaccinated at birth, and it is known that his mother was a carrier of hepatitis B virus or illness suffered in the third trimester of pregnancy, the newborn specific immunoglobulin is administered immediately. Further vaccination of children is carried out by 4-fold scheme of 0-1-2-12.
If a child is not vaccinated against hepatitis B at the hospital,his scheme of vaccination depends on the characteristics of the mother state. If she is not a carrier of the virus and could not stand it during pregnancy, the vaccination is carried out under the scheme 0-1-6. However, if the beginning of the vaccination coincides with 1 immunization against diphtheria, pertussis, tetanus (DPT) and polio (aged 3 months), it is possible the simultaneous use of these vaccines. The second hepatitis B vaccine can also be combined with administration of 2 doses of DPT and polio vaccine. When this vaccination is carried out 6 weeks after the administration of 1 (4.5 months). A third vaccination against hepatitis B in such cases is introduced in isolation aged 9.5-10 months or 12 months of age with 1 vaccination against measles, mumps and rubella. Unvaccinated baby recover from the mother (or mother-virus carrier) should be vaccinated according to the scheme 0-1-2-12. The coincidence of the timing of this vaccine with other (DPT, polio, measles-mumps-rubella) allows you to enter the simultaneous vaccination.
The choice of vaccine
In our country, vaccination against hepatitis Bare conducted with vaccines of both domestic and foreign production. Thus all vaccines licensed for use in the Russian Federation, are inactivated, ie, do not contain live virus and, therefore, can not cause the development of natural infection. Moreover, they contain in their composition does not itself killed virus, but only its small particle - recombinant (artificially recreated) antigen (protein of hepatitis B virus). In addition, there are combination vaccines that contain not only the antigen of hepatitis B antigens and pathogens of whooping cough, diphtheria and tetanus. This allows immunization against infections data simultaneously without additional injections. Currently, they are used usually in children with impaired vaccination schedule. For example, if the hepatitis B vaccination begins in only 3 months of age, it is advisable to combine it with a vaccine against whooping cough, diphtheria, tetanus (DPT). And preference should be given the combined vaccine rather than their separate administration. Second vaccination against hepatitis B, pertussis, diphtheria and tetanus - 1.5 months of the first dose - is also desirable to introduce a combined vaccine, as this reduces the number of injections. It should be noted that a change in the national immunization schedule (shift of the first hepatitis B vaccination in children who do not have a high risk of being infected in the first days of life, in the older age in the second or third month of life) combination vaccines are widely used to introduce the first and a second dose of vaccine against these infections.
Among the contraindications to the use of vaccinesHepatitis B allocate time (relative) and permanent (absolute). By the time any contraindications include acute illness or exacerbation of chronic, while vaccination is done after the child recovers (after 2 and 4 weeks, respectively). Permanent contraindications of vaccines are hypersensitivity to the drug, as well as severe reactions to previous administration of the vaccine.
Hepatitis B vaccines are usually transferredOK. Side effects (redness, induration and tenderness at the injection site being a violation and a small increase in body temperature to 37.5 degrees C) are rare, are of short duration, usually mild and generally do not require medical treatment. Very rarely can appear expressed allergic reactions: anaphylaxis or urticaria.