Second vaccination against hepatitis B. Why is the hepatitis B vaccine given to newborns? Hepatitis vaccination - where to give the injection

Hepatitis B is a fairly common disease in modern society.

In order to protect yourself as much as possible from it, you can use vaccination, as a result of which the body becomes immune to this disease. As a result of vaccination, immunity is developed that protects the body even in the presence of a potentially sick individual. Vaccination against hepatitis B is done in most developed countries, including in the CIS.

For some patients, hepatitis B vaccination is still mandatory. These include those who are forced to constantly communicate with a large number of people: teachers and nannies, doctors and nurses, social workers. Vaccination is also mandatory for children. But if the parents are strongly opposed, they can refuse by writing a statement.

Vaccination schedule and what to do if you missed a vaccination?

An adult can be vaccinated at any time if he has no contraindications to the vaccine. Hepatitis B vaccination schedule: 0-1-6. This means that the time interval between the first and second vaccination is 1 month, and between the first and third - 6 months. Remember, only vaccinations against hepatitis B can form stable immunity to the disease in the body. If there is not at least 1 vaccination against hepatitis B, we can say that the body is not completely protected from the disease.

But before the manipulation, you should know that the hepatitis B vaccine has contraindications:

In order to be formed as much as possible strong immunity, vaccinations against hepatitis B should be done in accordance with the schedule. But there are situations when, for some reason objective reasons revaccination was skipped. What can you do in this case?

If the second hepatitis B vaccine for adults is missed, it can be delayed up to 4 months. Moreover, the smaller the lag behind the immunization calendar, the more strong defense the body will form. After 4 months, vaccination should be done as if there was no first vaccination.

If you missed the third hepatitis B vaccine, you can get it within 18 months of the second vaccine. After this period, vaccination begins again, otherwise it is impossible to talk about the patient having developed immunity from hepatitis.

Validity of the vaccination and features of the manipulation

If vaccinations against hepatitis B were done according to the schedule, without violating the vaccination calendar, then we can say that the body has developed stable antibodies that will help it not become infected with hepatitis B Everyday life. Often, about 98% of vaccinated people do not get sick, even when in the company of infected people.

On average, immunity lasts for a period of 8 to 10 years, but for most it lasts a lifetime. But if vaccination is done in childhood, then immunity will last at least 22 years.

If it is necessary to check whether the body’s protective reaction to hepatitis has been preserved, you can take a special test, for which blood is drawn and the presence or absence of antibodies is determined.

The hepatitis B vaccine itself contains a large number of substances that help it to be effective and efficient for a long time. But these supplements are not very beneficial for the human body. This is one of the reasons why after vaccination your health may worsen or your temperature may rise.

These harmful additives to hepatitis B vaccinations include:

In order for a person to be able to withdraw such an amount without any problems toxic substances, before vaccination against hepatitis B, you need to establish processes for cleansing the body. Therefore, if you suffer from constipation, you first need to get rid of it.

In this way, you can get rid of toxins that have already accumulated in the body, and it will be much easier for it to cope with new ones, no matter how many of them enter. And after a week has passed from the date of vaccination, you can carry out the cleaning procedure again in order to get rid of the new intake of harmful substances.

To administer the drug, you need to inject into the muscle. This will generate maximum response immune system and the formation of antibodies. Subcutaneous administration of the hepatitis B vaccine is less effective and significantly reduces the body's response.

In Europe, the hepatitis B vaccine, administered subcutaneously, is considered to be a gross violation and is not considered effective. After some time, the injection is given again.

The question is often asked: where should the vaccine be administered? You can choose for yourself. According to the latest medical recommendations, better get vaccinated for hepatitis B, do it in the shoulder or hip. This is due to the fact that the muscles in these places are close to the skin and have few fat cells. There is a fairly large layer in the buttock subcutaneous fat, which makes it difficult to access the muscle. In addition, the injection can damage the nerves.

After vaccination has been carried out, it is advisable to help the immune system cope with the hepatitis B vaccination.

In fact, complications after it occur much more often than we are informed about it, and how many such cases are unknown. In order not to scare people away from vaccination, complications are often attributed to independent diseases.

In order for the effects on the body to pass almost unnoticed, you should continue taking medicines to support the liver, as well as a complex of vitamins and microelements, which the doctor will recommend.

After vaccination against hepatitis B according to the schedule, you need to follow some rules so as not to interfere with its effect on the body:

Composition and manufacturers of vaccines for adults

A modern vaccine is produced through the efforts of genetic engineers-biologists who, using special equipment, isolate a special gene from the genome of the virus that promotes the production of a special protein - HbsAg. This protein is then integrated into the genotype of the cell. When combined with proteins, it produces the so-called Australian antigen. When the cell culture increases to the required size, its growth is stopped. Next, using special techniques the viral protein is isolated and purified from additives.

After this, the viral protein is attached to a carrier, which is aluminum. It does not dissolve in liquid and, when ingested, releases the virus gradually over a long period of time. Thus, main goal The goal of the body is not to overcome the infection, but to form a stable immune system.

In our country, vaccinations against hepatitis B are represented by vaccines from several domestic manufacturers and several foreign ones. They are made in the same way, and the composition is also identical. The difference is often only in price, and you can decide which one to choose yourself.

IN modern world There are often big debates about whether the hepatitis B vaccine is necessary. Doctors recommend getting it. The following information supports this:

As for the disadvantages of the hepatitis vaccine, there are indeed minor side effects, but they are insignificant compared to the level of protection against infection, and they go away very quickly.

Don’t risk yourself and your health, get vaccinated against hepatitis on time!

Hepatitis refers to some dangerous infections that affect liver cells. Vaccination against hepatitis is not mandatory, but is important prevention which helps prevent the development of infection.

Today, many are refusing it due to the wave of general attitude towards any vaccination. But this is wrong, since the positive effect of vaccination against hepatitis is much more important than the possible and very rare negative consequences.

What are hepatitis A and B, what is their danger?

Hepatitis types A and B are viruses that, appearing in the human body, begin to multiply rapidly, affecting more and more healthy cells every day. They are transmitted from a virus carrier, have similar symptoms, but differ in consequences.

Hepatitis A

Hepatitis A is popularly called Botkin's disease or jaundice. It is relatively safe, does not lead to serious complications and is easily treated with early stages. The bacteria that provokes it makes itself known almost immediately as it appears in the body.

Hepatitis B

Hepatitis B manifests itself sharp increase temperature, nausea, vomiting, yellowing of the skin and eyes, dull feces, general malaise. But sometimes bacteria “sit quietly”, and pronounced symptoms are not visible until the late and severe stages. Infection is more severe and can develop into chronic diseases, including cirrhosis, liver failure and liver cancer. They lead to disability, coma and early death.

Important! According to statistics from the International Health Organization, in 2016 the mortality rate from this problem reached the level of mortality from tuberculosis, malaria, and HIV infection.

Routes of infection with hepatitis A and B virus

Botkin's disease is transmitted through the feces of a virus carrier. Hands that are not washed after using the toilet often become carriers of infection when shaking hands.

Hepatitis B has different routes of infection:

addiction;
dirty or unprocessed foods;
common household items with the virus carrier;
invasive medical procedures;
from infected mother to child;
poorly purified drinking water;
sexual intercourse

Important! Condoms do not provide a 100% guarantee of safety, but they reduce the risk of infection. In general, the disease is transmitted through any manipulation related to biological fluids body and blood.

What hepatitis are they vaccinated against?

Modern medicine has created vaccines against two types of disease - viruses A and B. Vaccination against hepatitis B was forced to be widely distributed throughout Russia, because the infection became an epidemic, and medicine became the only true salvation.

Vaccination against hepatitis is considered the most effective solution, preventing the spread of the problem, as well as its complications. The number of patients diagnosed with liver cancer after the creation of the hepatitis vaccine has decreased significantly. The positive trend is only growing.

What vaccines are used nowadays?

Different manufacturers produce hepatitis vaccines with approximately the same composition. They are interchangeable, the first and subsequent vaccinations can be done various drugs. For the full formation of immunity, it is only important to deliver all the vaccines, and preferably according to the developed scheme.

There are many different hepatitis vaccinations used in Russia, including:

Euvax B;
Engerix V;
Shanvak;
H-B-Vax II;
Eberbiovac;
Serum Institute;
Regevak;
Eberbiovac;
Biovac.

There are also combined vaccinations against hepatitis of both types. For example, products pharmaceutical company Smith Kline. The Bubo-M injection helps not only against hepatitis - it prepares the immune system for diseases such as diphtheria and tetanus.

Hepatitis A vaccination

The hepatitis A vaccine is not mandatory, but doctors advise everyone to get it because it is too easy to get infected. Vaccination against hepatitis is a kind of insurance not only for adults, but also for children.

Indications

A vaccine against hepatitis is urgently needed for people who live with a virus carrier or have discovered a serious liver pathology. Also indications for injection are:

living in an area where the incidence of hepatitis is extremely high;
work in the public service sector;
short-term travel to an area where virus A is widespread;
travel to a country with low social conditions.

In the latter case, the hepatitis vaccine is given several weeks before the approximate departure date, so that immunity has time to develop.

Contraindications

Contraindications include malignant blood diseases, pregnancy, exacerbations of chronic diseases, infections. You can only get vaccinated if at least a month has passed after a full recovery. And also a contraindication is an inadequate adverse reaction to a previous injection.

Before vaccination against hepatitis, the doctor asks a number of questions, conducts an examination, and takes the temperature to check for contraindications. If problems are detected or suspected, he refers to laboratory examination, which necessarily includes blood, stool and urine tests.

Composition of the hepatitis A vaccine

Modern hepatitis vaccinations produced using biotechnology are called recombinant. They are safe for the human body and are guaranteed to form specific immunity.

A special gene, HbsAg, is isolated from the virus genome using chemical treatment, which is then crossed with a yeast cell containing the viral protein. As a result, the Australian antigen is obtained, which is the basis of the vaccine. In addition, the vaccine contains aluminum hydroxide, preservatives that keep the components of the drug active, as well as other ingredients aimed at increasing the effectiveness and extending the service life of the substance.

The Australian antigen is contained in quantities from 2.5 to 20 mcg, which is due to the different needs of the human body. When vaccinating children, injections with an antigen content of about 5-10 mcg are used, and after the 19th birthday, the maximum amount can be used. In case of hypersensitivity or allergy, the antigen should not exceed 2.5-5 mcg.

Routes of administration of the hepatitis A vaccine

It is prohibited to vaccinate subcutaneously, so the substance is injected exclusively into the muscle, which allows it to penetrate the blood quickly and easily. Children are vaccinated in the thigh, and adults - in the shoulder, since the muscles in these areas are close to the skin and are very developed. The same cannot be said about the buttocks, where the muscle is located relatively deep and hidden by a layer of fat. That is why it is difficult to inject into it.

Everything you need to know about the hepatitis B vaccine

Vaccination against hepatitis B is not a mandatory measure, but it is worth considering that the disease is easy to contract, and its complications sometimes reach fatal outcome. For these reasons, doctors still recommend not refusing vaccination. But the last word in any case remains with the patient. Parents make decisions about hepatitis B vaccination for their children.

Who gets vaccinated against hepatitis B?

It is advisable for everyone, without exception, to get vaccinated. But there are also some categories of people for whom injection is required, because they are under threat. These include:

people who frequently receive blood transfusions;
service workers;
healthcare workers in contact with blood;
relatives of virus carriers;
people of non-traditional sexual orientation or those who are indiscriminate in choosing an intimate partner;
newborns;
drug addicts.

Residents of disadvantaged areas also need vaccination, because it is in such places that large outbreaks of the hepatitis virus have been found. Vaccinations against hepatitis B are considered an important and mandatory step to save the health of your liver.

Why is the hepatitis B vaccine necessary?

Vaccination against hepatitis B is necessary because the disease in some cases is asymptomatic and manifests itself in the form of serious complications. One day, a general malaise suddenly appears, your health worsens, and sudden or aching pain in the abdominal area.

The patient is sometimes unaware that he is ill—maybe even terminally ill. Vaccination helps prevent such consequences and not worry every time you feel discomfort in your stomach.

Anyone can become infected with the hepatitis virus, so everyone needs an injection. But people who are under threat every day need it especially urgently. If you have suspicious symptoms, you can be vaccinated more times than indicated in the special vaccination schedule. But before taking such a step, it is important to consult with your doctor.

What is advisable to do before and after vaccination against hepatitis B

Vaccination against hepatitis B requires some preparation. Before it you need to be examined by a doctor and special examinations. Blood, stool and urine tests are required. If necessary, the doctor refers you to specialized colleagues.

IN biochemical analyzes may find antibodies to the virus, which is why vaccination against hepatitis B is not given. The discovery means that the human body itself has developed immunity.

After administering the drug, you need to monitor the small scar that forms. You can't get it wet for the first three days, but you can take a gentle bath. Don't panic if water does get in. The wound is simply wiped dry with a napkin or towel.

1-3 months after the third vaccination, a blood sample is taken to confirm the presence of adequate immunity.

It is worth noting that alcohol in moderate doses does not harm the effectiveness of the antigenome.

Types of hepatitis B vaccines

IN modern medicine two types of hepatitis B vaccinations: individual and combined. The latter contain antibodies from other diseases to create comprehensive prevention a number of serious diseases. Most often they are given to infants.

A universal vaccine called Hexavac from a French manufacturer was recently released. It contains antibodies not only for hepatitis B, but also for diphtheria, whooping cough, polio, tetanus, and purulent-septic infections. It is considered the “pearl” of modern medicine.

Vaccination schedule for hepatitis B vaccinations

Experts have created a vaccination schedule against hepatitis B. It includes three schemes to choose from:

Standard. The first vaccination is given at newborn age, on the second day of life, then at one month and at 6 months.
An alternative regimen involves an additional vaccination for the child at 12 months. The remaining 3 are done according to the original schedule.
With an emergency vaccination regimen, 4 vaccines are performed - immediately after the birth of the child, then after a week and 21 days. The last one is at 12 months.

The standard regimen is performed for children born without pathologies. An alternative is needed if the child has health problems and is in dire need of boosting immunity.

An emergency regimen is required when a child is born from a mother with hepatitis. It is also suitable for an adult who is going to travel to a country with a risky epidemic situation.

A year after vaccination, it is necessary to revaccinate. Maximum possible interval between vaccinations – 4 months. This period does not allow the integrity of the procedure complex to be compromised.

Hepatitis B vaccination schedule

The first vaccination against hepatitis B, regardless of the chosen regimen, is performed in the maternity hospital at the birth of the child. The state gives a new mother the right to refuse an injection, citing her own and, preferably, reasoned opinion.

If the child does not have a bad reaction, a month or a week later (in an emergency), the drug is re-administered. The third vaccination occurs at 6 months or, if emergency vaccination is used, at 21 days after birth.

Typically, children receive 3 vaccinations, but after each one the body’s reaction is monitored. Typically, individual intolerance, which is possible in a child, manifests itself after the first injection.

With the alternative and emergency options, 4 injections are given. The first one, just like with a regular schedule, is the most important. If the drug is tolerated without problems, a series of similar vaccines are performed almost consecutively. The last, fourth, is applied after 12 months.

Reaction after hepatitis vaccination

Vaccination against hepatitis B in some cases causes certain reactions. They are different for each person and depend on individual tolerance to the drug. It has also been noted that domestic and foreign manufacturers are developing products with various additional components.

Domestic ones are more likely to cause negative reactions after vaccination, including:

gastrointestinal disorders;
migraine;
general malaise;
skin rashes;
diarrhea;
irritability;
increased body temperature;
itching, hardening or redness in the area of the injection wound.

Symptoms are observed in the first two days, after which they disappear. There were also cases with complications after vaccination. These include the appearance of hives, muscle pain, erythema nodosum, anaphylactic shock.

Any negative reactions after vaccination they appear extremely rarely and require immediate attention to an ambulance.

Contraindications for adults

Vaccination against hepatitis has many advantages and is desirable for everyone. But there are contraindications that prevent adults from getting the vaccine.

The vaccination schedule for children must include vaccination against hepatitis B. If for some reason it was not carried out, then vaccinations against hepatitis B for adults can be done at any age, up to 55 years. Viral is one of the most dangerous and unpredictable infections that is transmitted through blood and leads to dangerous complications(cirrhosis, liver failure, cancerous tumors). IN last years The spread of viral hepatitis is reaching epidemic proportions. You can protect yourself from hepatitis B only through vaccination, which ensures the body's immunity to infection.

Vaccination against hepatitis B for adults

Adults need vaccination against hepatitis no less than children, because it is very easy to become infected with the virus. A short contact with blood and other biological fluids (sperm, urine) containing the virus is enough. A very small dose is enough for infection, and the hepatitis B virus is resistant to external environment and remains viable even in dried blood stains for 2 weeks.

The main routes of infection with hepatitis B are:

medical procedures (injections, blood transfusions, surgical interventions);
from infected mother to child (vertical path);
unprotected sex with different partners;

You can become infected with the hepatitis B virus in the office of a cosmetologist or dentist, in a hairdresser or medical institution, if the rules of sterility of instruments are violated and there are damages on the patient’s skin (scratches, wounds, abrasions) through which the virus easily penetrates into the blood.

Do adults need to be vaccinated against hepatitis B if they infancy such vaccination was not carried out? Doctors insist that vaccination is mandatory, and adults can be vaccinated at any age. This the only way protection from dangerous infection and the opportunity to protect yourself from serious complications.

Vaccination against hepatitis B for adults is carried out with special preparations containing the viral protein. This vaccine is called recombinant and does not pose any danger to the body. To ensure lasting immunity, three injections must be given at certain intervals. The following drugs are considered the most popular and high-quality:

Regevak B;
Biovac;
Euvax B;
Eberbiovac;
Engerix;
The vaccine is recombinant;
Recombinant yeast vaccine.

Adult patients are vaccinated intramuscularly in the thigh or forearm. The choice is due to the fact that it is in this area that the muscles come closer to the skin and are well developed.

Administration of the vaccine subcutaneously or into the buttock does not give the desired effect and may lead to unwanted complications, cause damage to nerves and blood vessels. Today, it is possible to vaccinate against hepatitis A and B. Unfortunately, no vaccine has been found against hepatitis C, since this type of virus is constantly mutating and changing.

Indications for hepatitis B vaccinations

Vaccination against hepatitis B for adults is not mandatory and the decision to vaccinate is made by the patient himself. The procedure for administering the vaccine can be completed at the clinic at your place of residence (free of charge), or at private clinic on a paid basis. approximate cost full course vaccination costs 1000-3000 rubles. This amount includes the price of the vaccine and payment medical services. You can buy a quality drug at a pharmacy or order it online.

For some population groups at risk for hepatitis B, vaccination is mandatory. This list contains:

healthcare workers, especially those who come into contact with blood, sick people or are involved in the production of drugs:
social workers in contact with possible carriers of the virus;
workers of children's institutions (educators, teachers), catering establishments;
patients requiring regular transfusions of blood and its components;
patients before surgery who have not been vaccinated before;
adults who have not previously been vaccinated and family members of a virus carrier.

According to WHO, active immunity developed after vaccination lasts for 8 years. However, in many patients, protection against hepatitis B virus remains for 20 years after a single course of vaccine.

Contraindications and possible complications

Administration of the hepatitis B vaccine to adults is contraindicated in the following cases:

individual intolerance to the components of the drug;
allergic reactions to a previous vaccine administration;
exacerbation of chronic diseases;
acute infectious or colds;
general malaise, signs of food allergies;
pregnancy and lactation;
age after 55 years.

The injection is carried out when you feel normal and there are no ailments. In case of a cold, fever or exacerbation of chronic diseases, the vaccination must be rescheduled.

Adults usually tolerate vaccination well, but the occurrence of adverse reactions still possible. Doctors warn about them in advance. The body's general reaction to the vaccine may include weakness, malaise, fever, and chills. There may be redness and inflammation in the injection area skin accompanied by pain and swelling. In the future, tissue compaction and scar formation may occur in this area. In addition, adults may develop a number of complications in response to vaccination:

articular and muscle pain, abdominal pain;
upset stool, nausea, vomiting;
increase in the level of liver parameters in the tests;
decrease in platelet count in general analysis blood;
allergic reactions, including angioedema and anaphylactic shock;
enlarged lymph nodes;
reactions from the outside nervous system(convulsions, meningitis, neuritis, paralysis).

Sometimes, when the vaccine is administered, the patient experiences shortness of breath, accompanied by a short-term loss of consciousness. Therefore, vaccination is carried out in a specially equipped medical office equipped with everything necessary to provide first aid. After administration of the drug, the patient should be under the supervision of medical staff for at least 30 minutes in order to immediately receive help in case of an allergic reaction.

Hepatitis B vaccination schedule for adults

The hepatitis B vaccination schedule for adults is selected individually. After the first dose is administered, a break is usually taken, then subsequent doses are administered at different intervals. There are several basic schedules for administering the vaccine to adult patients, which determine how often injections are given in a given case.

First, standard option carried out according to the 0-1-6 scheme. That is, between the first and second vaccination there is a break of 1 month. And between the first and third injection the time interval is six months. This vaccine administration regimen is considered the most effective.
According to an accelerated scheme, those who have had contact with infected blood or biological material. In this case, the period between the first and second vaccination remains the same (30 days), and between the administration of the second and third dose it is reduced to 60 days. The regimen is repeated (re-vaccination) every other year.
Emergency vaccination is carried out for patients preparing for surgical intervention. In this case, the scheme is as follows - the second dose is administered a week after the first, and the third injection is given 3 weeks after the first.

How many vaccinations does an adult who has not previously been vaccinated against hepatitis B receive? Depending on the indications, the doctor may suggest any of the above regimens; it must be followed. If the vaccination period is missed and exceeds 5 months, then vaccination must be started again. If the third vaccination is missed, it can be done within 18 months after the first vaccine.

In the case when a person started immunization twice, and each time received 2 vaccinations (thus accumulating three injections), the course is considered completed. In order for strong immunity to be formed, it is necessary to take 3 injections; the validity period of hepatitis B vaccinations for adults, regardless of the type of drug, ranges from 8 to 20 years. Revaccination is a special program, the essence of which is to maintain the formed immunity. It is carried out for preventive purposes and is recommended to be completed 20 years after vaccination.

Before immunization, be sure to visit your local physician and find out possible contraindications. It is best to plan the vaccination procedure in advance and get vaccinated the day before the weekend. If any adverse reactions occur (fever, malaise), you will be able to rest at home in a calm environment. During this time, try to leave the house less and reduce your social circle.

The vaccination site should not be wetted for 1-2 days. Accept water treatments allowed 3 days after vaccination in the absence of fever and other undesirable reactions.

Alcohol does not affect the effectiveness of the hepatitis B vaccine. But you should still refrain from taking it. If you are planning a feast during this period, try to reduce the consumption of alcoholic beverages to a minimum.

Vaccination against hepatitis B is best protection liver from severe damage, which helps to avoid dangerous consequences, posing a threat human health and life and provides stable immunity that lasts for a long time.

Despite the heated public debate about the necessity/harmfulness of vaccines, it has been convincingly proven that today there is no other protection against dangerous infectious diseases except for vaccinations.

Vaccination against hepatitis B is carried out according to a certain scheme and is one of the most important in a person’s life: this vaccination is given the very first, within 24 hours from the moment of birth.

Few people know what the vaccination schedule for adults is. Meanwhile, this disease is one of the most common in human population, and every person is at risk of becoming infected with it during their lifetime. Let's consider the hepatitis B vaccination scheme for children and revaccination for adults.

The essence of any vaccination is the introduction into the body of:

weakened or inactivated microorganisms - 1st generation of vaccines;
toxoids (neutralized exotoxins of microorganisms) - 2nd generation of vaccines;
viral proteins (antigens) - 3rd generation of vaccines.

The drug administered during vaccination against hepatitis B belongs to the 3rd generation and is a vaccine containing surface antigens s (HBsAg), synthesized by recombinant yeast strains.

Genetic structure of yeast cells ( Saccharomyces cerevisiae) previously undergoes a change (recombination), as a result of which they receive a gene encoding surface antigen hepatitis B. Next, the antigen synthesized by yeast is purified from the base substance and supplemented with auxiliary substances.

After the vaccine is introduced into the body, antigens cause a reaction of the immune system, which is expressed in the production of antibodies corresponding to this antigen - immunoglobulins. These immune cells are the “memory” of the immune system. They remain in the blood for years, providing the opportunity to launch timely defensive reaction in case the real hepatitis B virus enters the body. Thus, vaccination, as it were, “trains” the immune system to recognize the dangers to which it must respond.

However, like any training, training the immune system requires repetition. To form strong immunity Both adults and children require several vaccinations against hepatitis B according to the vaccination schedule.

Hepatitis B vaccination schedule

On the territories of countries former USSR The hepatitis B vaccination schedule is used, which began to be used in 1982. In accordance with it, all children are subject to vaccination:

in the first days after birth;
one month after birth;
6 months after birth.

Thus, to form stable and long-lasting immunity, the hepatitis B vaccination regimen involves its three-time administration.

This rule does not apply to children at risk, i.e. those born to mothers infected with the virus. In these cases, the hepatitis B vaccination schedule is as follows:

in the first 24 hours - the first vaccine + antibodies to hepatitis B are additionally administered (the so-called “passive immunization”, designed to protect the child until his own antibodies are produced in response to the administered vaccine);
a month after birth - the second vaccine;
two months after birth - the third vaccine;
12 months after birth - the fourth vaccine.

Acquired immunity lasts for at least 10 years. However, this indicator is quite variable and can fluctuate among different people.

Vaccination scheme

There are three vaccination schedules in which adults are vaccinated against hepatitis B. We looked at the first two in the previous paragraph:

standard regimen of three vaccinations 0–1–6 (the second and third vaccinations are given 1 and 6 months after the first);
accelerated regimen of four vaccinations 0-1-2-12 (after 1, 2 and 12 months, respectively).

There is also the possibility of emergency immunization, which involves 4 vaccinations against hepatitis B for adults according to the schedule 0–7 days - 21 days - 12 months. This vaccination schedule is used in emergency cases, when, for example, a person urgently needs to leave for an epidemiologically dangerous region for hepatitis.

Correct use of any of the schemes forms stable and long-lasting immunity in an adult. An accelerated or emergency schedule of vaccinations against hepatitis B allows you to speed up the process at the beginning, i.e., to obtain sufficient protection by the end of the second (with an accelerated schedule) or by the end of the first (with an emergency schedule) month. However, the fourth vaccination, carried out after 12 months, is necessary for the formation of full long-term immunity.

Hepatitis B vaccination schedule

What to do if one of the injections was not given on time?

Maintaining your hepatitis B vaccination schedule is mandatory requirement vaccinations. Skipping vaccinations will not allow immunity to develop.

A slight deviation from the vaccination schedule of several days will not affect the antibody titer, stability and duration of acquired immunity.

If for some reason there is a deviation from the hepatitis B vaccination schedule, next vaccine must be entered as early as possible.

If there is a significant deviation from the vaccination schedule (weeks or months), you should visit a doctor and get face-to-face advice on further actions.

Revaccination scheme

The hepatitis B vaccination schedule for adults involves revaccination approximately once every 10 years until the age of 55, and after additional indications- and at a later age.

In some cases, for example, when an adult is not sure whether he has been vaccinated against hepatitis B and how long ago this might have happened, it is recommended to donate blood for the presence of antibodies to the surface and nuclear protein of hepatitis (HBsAg and HBcAg).

The amount of anti-HBs shows the strength of immunity to the hepatitis virus. Vaccination is indicated when the antibody level is less than 10 units/l, which is interpreted as complete absence immunity to viral antigens.

If antibodies to nuclear antigen (anti-HBc) are detected, vaccination is not carried out, since the presence of these immunoglobulins indicates the presence of the virus in the blood. The final clarification can be given additional research(PCR).

Revaccination against hepatitis B for adults is carried out according to standard scheme three vaccinations 0-1-6.

What vaccines are there for hepatitis B?

Today, the market offers a wide range of both mono- and polyvaccines against hepatitis B for adults and children.

Mono-vaccines produced in Russia:

Combiotech;
Microgen;
Regevak.

Mono-vaccines produced by foreign laboratories:

Engerix V (Belgium);
Biovac-B (India);
Gene Vac B (India);
Shaneak-V (India);
Eberbiovak NV (Cuba);
Euvax V (South Korea);
NV-VAX II (Netherlands).

The listed vaccines are of the same type: they contain 20 μg of viral antigens in 1 ml of solution (1 dose for an adult).

Since in adults the immunity to many infections acquired in childhood has time to fade, it is advisable to revaccinate against hepatitis B according to the scheme discussed above using polyvaccines.

Among these multivaccines for adults can be named:

against diphtheria, tetanus and hepatitis B - Bubo-M (Russia);
against hepatitis A and B - Hep-A+B-in-VAK (Russia);
against hepatitis A and B - Twinrix (UK).

Current hepatitis B vaccines

Is the vaccine safe?

During the use of the vaccine, more than 500 million people were vaccinated. However, no serious side effects or negative influence on the health of neither adults nor children.

Opponents of vaccination, as a rule, refer to the unsafety of the preservative ingredients in the drug. In the case of hepatitis vaccination, such a preservative is a mercury-containing substance - merthiolate. In some countries, for example in the USA, vaccines containing merthiolate are prohibited.

No reliable data has been obtained that 0.00005 g of merthiolate - which is exactly how much is found in one injection of the vaccine - would have an effect on human health.

In any case, today it is possible to vaccinate an adult with a drug without a preservative. The Combiotech, Engerix B and NV-VAX II vaccines are produced without merthiolate or with a residual amount of no more than 0.000002 g per injection.

How much can vaccination prevent infection?

Vaccination against hepatitis B, carried out in accordance with the schedule for people who do not suffer from immunodeficiency state, prevents infection in 95% of cases. Over time, the intensity of immunity to the virus gradually decreases. But in any case, even if a person gets sick, the course of the disease will be much easier, and recovery will be complete and faster. Read about how the disease is transmitted.

Useful video

For more information about hepatitis B vaccination, watch the following video:

Conclusion

Vaccination against hepatitis B, done according to the scheme, is practically the only 100% way.
Vaccination is mandatory for children in the first year of life.
Revaccination of adults is carried out at will (unless there are indications to the contrary).
The standard vaccination schedule involves the administration of 3 vaccines according to the hepatitis B vaccination schedule (0–3 - 6 months).
Acquired immunity lasts for approximately 10 years.

Vaccine options

All modern vaccines for prevention viral hepatitis B are produced using genetic engineering technology. A segment of the virus genome is introduced into the genetic material of baker's yeast, which is responsible for the production of the “Australian” (HBsAg) antigen. Vaccines consist of almost 90-95% antigen and only 5-10% of other components.

The following vaccinations are used in Russia: “Vaccine against hepatitis B recombinant”, “Regevac V”, “Engerix V”, “Bubo-Kok”, “Bubo-M”, “Shanvak-V”, “Infanrix Hexa”, DTP-GEP B All of these vaccines are weakly reactogenic, interchangeable - that is, the course of vaccinations can be started with one vaccine and finished with another (although it is still preferable to vaccinate within the course with a vaccine from the same manufacturer). They are intended for vaccination of children and adults against hepatitis B.

The second, non-specific, but important component of vaccines is aluminum hydroxide. This substance is a so-called depositing agent in vaccinations and is designed to enhance the immune response. Its purpose is aimed not only at strengthening the immune response, but also at the dosed release of antigen from the site of vaccination against hepatitis B. The need for it is dictated by the fact that, as a rule, vaccines based on only one antigen are weakly immunogenic, and in order to achieve the required levels of formed antibodies required or injection more antigen, or an increased reaction to it.

Principles and purposes of vaccination

About 780,000 people die every year from the consequences of hepatitis B. Vaccination is not only the main and important means prevention of viral hepatitis. It may also protect against primary liver cancer. The basis for preventing hepatitis B is the vaccine against this disease. According to WHO recommendations, all children infancy should receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours. The dose given at birth should be followed by two or three subsequent doses to complete the vaccination series. In most cases, one of the following two options is considered optimal:

A three-dose hepatitis B vaccination regimen in which the first dose (of monovalent vaccine) is given at birth and the second and third doses (of monovalent or combination vaccine) – simultaneously with the first and third doses of DPT vaccination;
A four-dose regimen in which the first dose of monovalent vaccine given at birth is followed by 3 doses of monovalent or combination vaccine, usually given along with other vaccines as part of routine childhood immunization, is indicated for children born to mothers infected or with hepatitis B.

After completing a full series of vaccinations, more than 95% of infants, children of other age groups and young people appear protective levels antibodies. Protection lasts for at least 20 years and possibly a lifetime. All previously unvaccinated children and adolescents under 18 years of age should receive the vaccine if they live in countries with low or moderate endemicity. By the end of 2013, hepatitis B vaccine for infants had been introduced nationally in 183 countries. Global coverage of three doses of hepatitis B vaccine is estimated at 81%, and for Western Pacific countries it reaches 92%.

Vaccine effectiveness

The vaccine is different high degree safety and effectiveness. Since 1982, more than one billion doses of hepatitis B vaccine have been used worldwide. In many countries where 8% to 15% of children typically have chronic viral infection hepatitis B, vaccination contributed to a decrease in rates chronic infection among immunized children to less than 1%.

After a course of immunization, sufficient immunity is developed in 90% of vaccinated people. With the help of vaccinations, it is possible to reduce the incidence of hepatitis by 30 times and prevent at least 85-90% of deaths occur due to this disease. In addition, the risk of getting sick in those born to mothers who are carriers of the infection is reduced by 20 times.

Many researchers call the hepatitis B vaccine the “first cancer vaccine” because it prevents the development of HBV infection, which ultimately leads to hepatocellular carcinoma.

Post-vaccination reactions

Modern vaccinations against hepatitis B are characterized by an extremely high degree of purification, up to 95% of their volume is represented by antigen. In addition, vaccinations consist of only one antigen, the content of which is measured in micrograms. Both of these factors determine that in practice these vaccines are among the safest, “mildest”, and easily tolerated.

The most typical post-vaccination reactions to the administration of hepatitis B vaccines are local reactions (i.e. occurring at the injection site). Their frequency is fairly standard for all available vaccines - up to 10% (maximum) of vaccinated people report symptoms such as redness, slight thickening, and discomfort during active movements. Prevalence local reactions is explained by the action of aluminum hydroxide, a substance that is specifically designed to enhance inflammatory reaction at the site of drug administration so that as many immunocompetent cells as possible come into contact with the injected antigen.

Much less frequently, with a frequency of about 1% (maximum - 5%), the so-called so-called general reactions, i.e. affecting the body as a whole - a slight increase in body temperature, mild malaise, etc. All of the above reactions are normal (expected), appear within 1-2 days from the moment of vaccination and disappear without treatment within 1-2 days.

Risk of post-vaccination complications

In isolated cases, allergic reactions up to anaphylactic shock may occur. Heavy allergic reaction develops in less than 1 case per 600,000 vaccinations.

Contraindications

The only specific and absolute contraindication for hepatitis B virus vaccines is an allergy to products containing baker's yeast. Temporary contraindications: severe reaction (temperature above 40 o C, swelling, hyperemia > 8 cm in diameter at the injection site) or complication (exacerbation chronic diseases) on previous administration of the drug. Routine vaccination postponed until completion acute manifestations illness or exacerbation of chronic diseases. For mild ARIs, acute intestinal and other diseases, vaccinations can be carried out after the temperature has normalized.

When to vaccinate?

The first vaccination against hepatitis B is done in the maternity hospital, preferably in the first 24 hours of the child’s life. In the 1st month, the second vaccination is given, and the third – 6 months after the start of vaccination.

For children at risk, the scheme looks different: 0-1-2-12 - the first dose at the start of vaccination, the second dose - a month after the start of vaccination, another (third) dose - two months after the start of vaccination, and the fourth dose – 12 months from the start of vaccination.

Ask a question to a specialist

Question for vaccination experts

Questions and answers

She gave birth to a child in Russia, and in the maternity hospital the baby was immediately given BCG and a hepatitis B vaccination. For the first two months, no vaccination was carried out; there was a medical exemption due to jaundice. At three months we returned to Japan, where we live permanently. Here, at three and four months, three vaccinations were given: DPT, against pneumonia, against influenza (influenza b). There is a completely different vaccination calendar and in connection with this there are two questions: when should we get the second and third hepatitis B vaccinations? Is it possible to give 4 vaccinations at a time (that’s how they do it here)?

According to WHO recommendations, several vaccines can be administered simultaneously, only in different areas bodies. Against hepatitis B, you can get 2 vaccinations at 5 months, and a third at 6 months; the vaccination can be combined with other vaccines. According to the Japanese vaccination calendar, vaccination is carried out three times according to a scheme similar to the Russian one 0-1 (4 weeks) - 6 months (20, 24 weeks). Check for yourself, maybe you have already been vaccinated against viral hepatitis B?

In the maternity hospital, the child was vaccinated against hepatitis and BCG. At 1 month medical withdrawal due to jaundice - missed the second hepatitis vaccine. At 3 months again a waiver from all vaccinations, incl. and from hepatitis, due to low hemoglobin (103). At 4 months again the pediatrician was rejected due to dysbacteriosis.

Now we are starting a two-week course of massage, the pediatrician also does not recommend vaccinations. But right before the start of the course he suggests getting vaccinated against hepatitis.

Please tell me, in our case, does the hepatitis vaccination schedule start anew? And at 6 months. should we do all other vaccines according to standard schedules?

Answered by Kharit Susanna Mikhailovna

If you manage to get vaccinated against viral hepatitis at 5 months, then the vaccination counts and you should get the 3rd vaccination at 6 months. If the interval between the first 2 vaccinations against hepatitis B is more than 5 months, you need to start again, i.e. 1 vaccination was missing.

The first vaccination against hepatitis B was given at 7 months. Then there was a big break. The second was done at one year and 6 months, and the third at one year and 7 months. Do I need to get another vaccination, since there was a long break between the first and second?

It is advisable to follow the schedule according to which hepatitis vaccinations are given exactly. If the vaccination is delayed by more than three months, the whole scheme starts again from the first vaccination, meaning you will need to have another vaccination at two years. (scheme 0-1-6). However, the instructions for use of "ENGERIX - V" indicate: if the interval between the first and second vaccinations is extended by 5 months. and more than the third vaccination is carried out after 1 month. after the second one.

On November 11, 2015, a daughter was born. In the maternity hospital, the child had 2 BCG vaccinations and against hepatitis B (manufactured in Moscow), the second vaccination against hepatitis was given exactly a month later (manufactured in Moscow), the third vaccination was missed and not given. Now the child is 1 year old, we plan to put Pentaxim 3 times in a month and a half. Our schedule has shifted. Tell me, when and how to get the third vaccine against hepatitis B? When can you get vaccinated against pneumococcal infection? When to get vaccinated against rubella, measles and mumps? What can be combined with what? What will our future vaccination schedule look like?

Polibin Roman Vladimirovich answers

It is advisable to follow the schedule according to which hepatitis vaccinations are given exactly. Changes are allowed with the approval of the doctor, however, if the vaccination is delayed by more than three months, the entire scheme begins again, from the first vaccination.

According to the national calendar preventive vaccinations, when the timing of vaccination is shifted, the introduction of vaccines used within the framework of National calendar preventive vaccinations, on the same day with different syringes in different parts of the body. The only exception is the vaccine for the prevention of tuberculosis! If vaccines are not administered on the same day, then the interval between vaccinations should be at least a month.

The Pentaxim vaccination schedule is as follows.

1) The intervals between doses are maintained and amount to 1.5–1.5 months. And 12 months for revaccination.

2) After a year of life, the first dose is administered in full, and the second, third and fourth (booster) dose is administered without the Hib component. The Pentaxim vaccine without the Hib component can be used up to six years of age. In cases where there is no need to use the Hib component, the Tetraxim vaccine can be used. This is a biological product from the same manufacturer, similar to Pentaxim, but without the hemophilic component.

Vaccination of children for whom immunoprophylaxis against pneumococcal infection was not started in the first 6 months of life is carried out twice with an interval between vaccinations of at least 2 months.

Vaccination against measles, rubella and mumps. If vaccination is postponed for a long time, it is done as close to the schedule as possible. In this case, the interval between the administration of the vaccine and revaccination should be at least 4 years.

On the website, in the article “IT IS POSSIBLE AND NEEDED TO DEFEAT HEPATITIS B” dated August 17, 2015, it is written that “under no circumstances does the vaccination course begin anew” (in the context of a violation of the childhood vaccination schedule).

1 question: why is it so categorically impossible to start over from v1 (according to the 0-1-6 scheme, without serology control)? Are these words spelled out in the legislation or does this have real clinical grounds?

Question 2: if an adult has an unknown vaccination history (maybe the first 2 vaccinations were two years ago) and there is no opportunity to do serology, how to get vaccinated against Hep.B?

Polibin Roman Vladimirovich answers

The experience of many years of observation has shown that three vaccinations against Hepatitis B, given at any interval, protect in 95% of cases. If a person has contact with a patient with hepatitis B and his risk of infection is higher than the statistical average, then if the vaccination schedule is violated, it is necessary to conduct an examination for the titer of antibodies to the Hepatitis B virus, as well as an examination for markers of the infection itself. And, if antibody titers are not protective, then additional vaccinations are carried out.

If the vaccination history is unknown, the person is considered not vaccinated and receives the full 0-1-6 month regimen. If he is in contact with patients, then first he is examined for markers of the infection itself, and if the markers are negative (Hbs antigen), vaccination is carried out according to the appropriate scheme.

My child's vaccination schedule for Hepatitis B was disrupted.

1st vaccine: 12/25/2014 (in the maternity hospital), 2nd vaccine: 09/20/2016 On this moment(11/17/2016) the doctor refused to vaccinate and said to come in February 2017. for 3 vaccinations. The question is: is it necessary to start vaccination against Hepatitis B again and according to what scheme?

Answered by Kharit Susanna Mikhailovna

Continue to be vaccinated against viral hepatitis B. Vaccination in 2014 is no longer counted, but continue the vaccination performed in September 2016 according to the following scheme: 2 B against hepatitis B in the near future, 3 vaccination against hepatitis B - from 03.20.17.

IN one month old The child did not receive the next vaccination against hepatitis B. The child is healthy. The local doctor said, if you have time to see specialist doctors before the child is 2-3 months old, then we’ll do it. Please tell me whether it is legal to violate the vaccination schedule in this way and whether this will affect the effectiveness of the vaccine?

Answered by Kharit Susanna Mikhailovna

You can safely be vaccinated against viral hepatitis B, since the instructions for the drug indicate that the maximum allowable interval between the first and second vaccination is 5 months. Previously, in the vaccination calendar, children in the first year of life were vaccinated according to the 0-3-6 month schedule. The main thing is to get 3 vaccinations at 6 months.