HBV vaccination: features, explanation and effectiveness

The HBV vaccination is a vaccination against viral hepatitis B. It reliably protects a child or adult from this dangerous disease. The first drug for vaccination was created back in 1982, but in Russia the widespread use of this drug began in 2002. Currently, HBV is included in the vaccination schedule. The hepatitis B vaccine is given to newborns. Many mothers have a question: “Why vaccinate your baby at such an early age?” Let's find the answer together.

What is hepatitis B?

Hepatitis B is a viral disease that causes inflammation of the liver. There is jaundice, fever, pain in the right hypochondrium. The disease can cause serious consequences such as cirrhosis and liver cancer.

The virus itself does not have a harmful effect on liver cells. But it disrupts the functioning of the immune system. As a result, your own lymphocytes begin to destroy the liver. We can say that the virus triggers an autoimmune process.

The disease is extremely common. According to the World Health Organization, about 300 million people are asymptomatic carriers of the virus. And about 1 million people die every year from complications of hepatitis. These are mainly children, teenagers and young people under 20 years of age.

The insidiousness of the virus lies in the fact that in young children hepatitis most often occurs without pronounced symptoms. And the younger the child, the more likely it is that the disease will not have any symptoms. If a baby has become infected with hepatitis B and has obvious manifestations of jaundice, then this course of the pathology is considered more favorable. This suggests that the baby’s immunity is resisting infection. Conversely, asymptomatic hepatitis means that the body is not fighting the virus.

Why is it given to children and adults?

Although the hepatitis B virus itself does not harm liver cells, it affects the immune system, triggering autoimmune processes. The liver is destroyed by its own lymphocytes. The disease is extremely common, many people are carriers of it, and about 1 million people die every year due to its consequences. This is the first vaccination that children receive in the maternity hospital.

Hepatitis B is most dangerous for children . It often occurs asymptomatically or with symptoms of other diseases, causing irreparable damage to the liver. 90% of sick children experience complications, and all sick children remain virus carriers for life.

You cannot become infected with HBV through household contact. But a person inevitably visits various establishments where there is a possibility of cuts, scratches, and injections (hairdressing salon, dentistry, testing, etc.).

And the virus can enter the resulting wounds through the use of insufficiently cleaned instruments or contact with a virus carrier.

Infection can also occur through sexual contact.

All young people under 18 years of age are subject to immunization, if for some reason they have not been vaccinated previously.

The HBV vaccine produces protective levels of antibodies in 90% of children and young adults of all ages. The effect is observed for at least 20 years, and sometimes throughout life, preventing the development of hepatitis B. And the risk of getting sick in children of infected mothers is reduced by 20 times.

Where can a child become infected?

Sometimes mothers do not want to vaccinate their newborns with HBV. Women mistakenly believe that if they were tested for hepatitis during pregnancy, then their baby cannot be sick.

There are the following routes of transmission of the hepatitis virus:

• through blood;
• household contact;
• from the mother during childbirth or in utero;
• sexual tract.

Hepatitis cannot be contracted through airborne droplets, water or food. If we talk about infants, they most often get the infection from their mother. And even if a woman was tested for hepatitis during pregnancy, this does not exclude the possibility of infection of the baby. After all, the expectant mother could, after the examination, visit hospitals, undergo cosmetic procedures or dental treatment, and this increases the risk of infection. Children are usually infected intrauterinely due to pregnancy pathologies. A healthy placenta protects the fetus from infection. Therefore, more often newborns become infected with hepatitis during passage through the birth canal of an infected mother.

An unvaccinated baby can get the virus through medical procedures: blood transfusions, surgeries, tooth extractions. This is the most common route of infection in children. A child can become infected through everyday contact with sick family members or peers. The hepatitis B (HBV) vaccine protects children from this danger.

Can hepatitis be cured?

Hepatitis B is quite difficult to diagnose in children. Often the disease is disguised as other pathologies and occurs with symptoms of respiratory diseases. There is only one way to detect the virus - a blood test from a vein for the “Australian” antigen. But often the doctor assumes that the child has ARVI rather than hepatitis, and the diagnosis is not carried out in a timely manner.

Treatment for hepatitis B is very expensive. Only special antiviral drugs—pegylated interferons—help to achieve stable, long-term remission. But even these expensive medications do not completely get rid of the virus, but only stop the process of liver destruction. In addition, such medications have many side effects. Such a serious and complex disease is easier to prevent than to treat. For the purpose of prevention, they are vaccinated with HBV.

How does the vaccine work?

A small amount of protein containing antigen is removed from the surface of the virus. It is placed in a yeast nutrient medium, which ensures enhanced cell division. As a result, a substance necessary for the drug is formed. It is separated from the yeast solution, aluminum hydroxide and a preservative are added.

After the vaccine is introduced into the human body, the protein comes out under the influence of aluminum hydroxide. The body begins to produce antibodies to the antigen. As a result, lasting immunity against the hepatitis B virus is formed.

What does the name “HBV vaccination” mean? The abbreviation is explained as follows: HBV is the hepatitis B virus.

Drugs used for vaccination against hepatitis B and their composition

There are two types of vaccines used for HBV vaccinations:

1. based on blood plasma;
2. recombinant.

They are similar in effectiveness, degree of immune protection, require the same temperature conditions during storage, and do not allow freezing. Both vaccines completely replace each other.

The first type of vaccine is obtained from purified HBsAg isolated from the blood plasma of patients with chronic HBV infection. In the production of the second type, HBsAg is used, synthesized in yeast or mammary gland cells.

The HBV vaccine can be monovalent, i.e. providing protection only against the hepatitis B virus. And it can be combined, i.e. used in combination with other vaccines.

The first vaccination in the maternity hospital must be carried out with a monovalent vaccine.

Preparations for vaccination

Currently, clinics administer vaccinations with the following types of drugs for mass vaccination:

• "Recombinant yeast vaccine against hepatitis B."
• "Engerix".
• "Eberbiovak."
• H-B-VAX II.
• "Regevac V".
• "Biovac".
• "Euvax."
• "Boobo-cock."

The Russian drug “Recombinant yeast vaccine against hepatitis B” does not contain preservatives. It is recommended to vaccinate children using these means.

You should pay attention to the drug “Bubo-kok DTP + HBV”. It can be classified as a combination drug. At the same time, they give the DTP vaccine and give the HBV vaccine to children. The deciphering of the name of the drug means - adsorbed pertussis-diphtheria-tetanus vaccine (DTP) and viral hepatitis B (HBV). Thus, this vaccination protects the child from several diseases at once.

There is another variety of this remedy called “Bubo-M ADS-M+HBV”. In addition to hepatitis, this vaccine works against diphtheria and tetanus, but does not prevent whooping cough.

All hepatitis B vaccinations contain only antigen. There are no microorganisms in them, as these are inactivated vaccines.

How are newborns vaccinated?

For complete protection against hepatitis B, several injections of the vaccine are required. Vaccinations for newborns are given according to the following scheme:

1. The drug is first administered within 12 hours after birth. It is important to vaccinate against hepatitis before the BCG vaccination (for tuberculosis), since they cannot be done on the same day.
2. The second and third injections are given at 3 and 6 months.

After the first vaccination, 50% of children develop immunity against hepatitis, after the second - 75%, and the third vaccination provides 100% protection against the disease.

This schedule is suitable for healthy infants who are not at risk. But there are newborns with an increased likelihood of infection. These are children whose mothers suffer from hepatitis, are virus carriers, or were not examined for this disease during pregnancy. In such cases, a rapid HBV vaccination regimen is used. What does it mean? Vaccination is carried out not 3, but 4 times according to the following schedule:

1. The first injection is given within 12 hours after birth.
2. The second and third injections are given at 1 and 2 months, and then repeated at the age of 1 year.

If the vaccine was given in infancy, it will last for about 22 years. Then, as an adult, you can repeat the vaccination or take an antibody test to ensure that you have immunity against hepatitis. For some people, the vaccine may last a lifetime.

Sometimes it happens that the recommended timing of vaccinations is violated due to an acute illness of the child. In this case, we must remember that the minimum interval between injections cannot be less than 1 month. As for the maximum interval, it should not exceed 4 months for the second vaccination and 18 months for the third.

Many parents have heard of the HBV-1 vaccine. What kind of vaccine is this? This is how the calendar indicates the first administration of the hepatitis B vaccine.

Will the new drug help?

Gam-COVID-Vac was carefully studied in preclinical trials on small and large animals - so experts sought to prove safety and possible toxicity, as well as immunogenicity.

Scientists specifically selected the most sensitive representatives of mammals (Syrian hamsters and various primates) in order to assess all risks as accurately as possible. Positive results of the study allowed us to move on to the next stage.

Tests on volunteers

Information about the first studies was published in early autumn 2021 - the first and second phases involved 76 people. Experts noted that side effects are minimal, and no deaths have been recorded, so we can move on to the third phase.

It started on September 7, the end of testing was on November 24. Features of the third phase:

• a huge number of subjects, which made it possible to obtain accurate statistics (more than 16,000 people, with 5,435 being placed in the placebo group);
• Efficiency up to 95% has been recorded;
• most adverse reactions are group 1, that is, mild (7485 cases were documented).

Scientists also recorded serious side effects (68 events), however, none of them were associated with vaccination.

Safety

According to research, the majority of those vaccinated do not experience side effects (85%), while the remaining 15% experience mild discomfort:

• hyperthermia - increase in temperature to 38-39 degrees;
• muscle and headache;
• weakness, irritability;
• redness at the injection site.

Experts clarify: theoretically, vaccination can complicate the course of various genetic pathologies, but is not capable of causing them - hereditary diseases, in principle, cannot be directly provoked by external factors. This applies mainly to chronic autoimmune diseases, because Sputnik V activates natural immunity.

Speaking about the safety of a person who has been vaccinated with two doses of the vaccine, it is worth considering that the drug was created on an adenoviral vector, which was first used back in the 70s of the last century. The technology is considered harmless, as proven by a lot of research over the past 50 years.

It is important to know! Using this platform, three different drugs for vaccination against Ebola were recently created. According to the latest data, more than 60,000 people have received the vaccine in Africa, China and Russia. The technology also made it possible to release two experimental cancer drugs that successfully completed 250 trials. Thus, viral vectors are not a new platform, but they are a very effective one.

Efficiency mark

Another reason why residents of the Russian Federation still doubt whether to get vaccinated is mass criticism by foreign experts. However, evidence of effectiveness in the form of reports on studies of the drug on volunteers was published just a month after the drug was presented to the public.

The final data, presented in The Lancet in early February of this year:

• group from 18 to 30 years old - average efficiency 91.9%;
• group from 31 to 40 years old - average efficiency 90.0%;
• group from 41 to 50 years old - average efficiency 91.3%;
• group from 51 to 60 years old - average efficiency 92.7%;
• group over 61 years old - average efficiency 91.8%.

Thus, the overall effectiveness for the entire population was 91.54%. The same study analyzed the indicator depending on the time elapsed after intramuscular administration of the drug:

• immediately after the first injection - up to 73.1%;
• two weeks after the first injection - 87.6%.

The maximum effectiveness is achieved after the second dose of Sputnik-V.

After the publication of these studies, many foreign experts changed their opinion. Dean Winslow, an infectious disease physician at Stanford Medical Center, spoke positively about the Russian vaccine, believing that it will play a significant role in the fight against the disease.

A specialist in the same profile, Daniel Kuritskis, head of the Harvard Medical School, noted not only the effectiveness, but also the huge advantage of the vaccine in the form of ease of storage - standard refrigerators are enough to maintain the quality of the drug. This makes it easier to deliver the medicine to areas where it is difficult to reach suitable temperatures for conventional vaccines.

How are older children vaccinated?

If for some reason the child was not vaccinated in infancy, then vaccination can be carried out at an older age. An antigen test is not necessary before vaccination. The injections are given three times, and the following scheme is followed:

1. First vaccination.
2. Second injection after 1 month.
3. The third injection six months after the first.

If a child has hepatitis or is a carrier of the infection, then the injections will not harm him, but will not bring any benefit. The vaccine can last from 15 to 20 years. After this period, you should take an antibody test and, if necessary, repeat the vaccination.

Vaccination of adults

The HBV vaccine is given to adults quite often. The vaccine is new, and most people did not receive hepatitis prophylaxis during childhood. Usually 3 injections are given:

• The first injection is administered immediately upon visiting the doctor.
• The second one is in 1 month.
• The third - six months after the first.

Immunity can last from 8 to 20 years. After this period, revaccination is done. Health care workers have an increased risk of contracting hepatitis, so vaccinations are required for them every 5 years.

If a person requires revaccination against other infections, combination drugs, such as Hexavak, can be used. This is a convenient option for HBV vaccination in adults. The decoding of the designation of the vaccine “DTP + hepatitis B + inactivated polio vaccine + Act-HIB” indicates that the product provides immunity not only from hepatitis. The drug protects against diphtheria, tetanus, whooping cough, polio, as well as against Haemophilus influenzae infection, which causes inflammation of the respiratory system and sepsis.

If a person has had contact with a patient with hepatitis, then an emergency vaccination regimen may help in the first 2 weeks:

1. The first injection is given immediately upon presentation to a medical facility.
2. The second one is on the 7th day.
3. The third is on the 21st day.
4. The fourth - 6-12 months after the first.

Along with the vaccine, immunoglobulin with ready-made antibodies against hepatitis B is administered. This regimen can only be used for adults and adolescents; it is not used for small children.

Vaccination scheme

The most commonly used three-dose and four-dose vaccination regimens are:

• with a three-dose regimen, the 1st vaccination (V1) is given in the maternity hospital. The 2nd (V2) and 3rd (V3) are done simultaneously with DPT vaccinations. The 2nd is done a month later, and the 3rd – six months after the start of vaccination. The last two vaccines used can be either monovalent or combined;
• a four-dose regimen is indicated for children of mothers sick or infected with hepatitis B. The first vaccination is also given immediately after birth with a monovalent vaccine, and the remaining 3 (combined or monovalent vaccine) are combined with other vaccinations included in the childhood immunization complex. The 2nd (V2) dose is administered a month later, the 3rd (V3) - two months later, the 4th (V4) - a year after the start of vaccination.

The same schemes are followed for vaccinating adolescents and adults who have not received such a set of vaccinations before. All vaccination schedules and timing are determined by Order No. 125n of the Ministry of Health of the Russian Federation. A single dose for children and youth under 19 years of age is 0.5 ml.

Vaccinations must be carried out strictly according to the instructions and be sure to follow the vaccination schedule. If the timing of vaccination is delayed, the body's immune response will be weaker, and the acquired protective functions of the body will not be able to guarantee 100% protection against the disease.

How to prepare for vaccination?

Vaccination against hepatitis B does not require special preparation. You just need to measure your temperature before the procedure. In case of acute respiratory diseases, vaccination should be postponed. If the body temperature is more than +37 degrees, then you should postpone vaccination.

Sometimes doctors advise taking an antihistamine tablet before vaccination to prevent allergies. However, this is not necessary. This recommendation should only be followed if the child or adult has had allergic reactions in the past.

Reactions to the vaccine

A side effect after vaccination may be redness of the injection site and the formation of a lump. Children may develop a fever. Such reactions of the body are normal and do not require any additional intervention.

Vaccine Regevak B

Contraindications to vaccination

This vaccination is quite safe and has few contraindications. It is necessary to refrain from vaccination in the following cases:

• during pregnancy;
• during acute infectious diseases or during exacerbation of chronic ailments;
• if you are intolerant to any component of the drug;
• if you are allergic to yeast or to previous vaccinations.

It should be noted that if a baby has a birth injury or hemolytic jaundice due to a conflict on the Rh factor, then this is not a contraindication to vaccination.

Side effects

Since the vaccine is inactivated and does not contain microorganisms, side effects are extremely rare. Usually there is a slight rise in temperature and skin reactions: redness, thickening and slight soreness at the injection site. Allergic reactions are possible only in rare cases.

Often mothers are afraid or do not consider it necessary to vaccinate their children against hepatitis B. But their fears are in vain, since the vaccine has a high degree of safety. Parents are mistaken when they believe that a newborn cannot become infected with this virus. Infection can occur at any age. Only timely vaccination can protect a child from a dangerous disease.

Price and reviews

Today, HBV vaccinations are done with domestic and imported vaccines. They are all similar in properties and composition, but differ in price.

The most popular vaccinations are:

• Hepatitis B vaccine (Russia) – from 1417 rubles. (children)/ 1866 rub. (adult) for 10 doses;
• Engerix V (Belgium) – from 4810 rub. (adult) for 25 doses;
• Regevak V (Russia) – from 883 rubles. (children)/910 rub. (adult) 1 dose.

The use of any of the available vaccinations is determined by the availability of their purchase in pharmacies and price. Reviews left by adult patients and mothers of vaccinated babies are mostly positive.

Some mothers doubt the need for such vaccination for their babies, but many years of vaccination practice show that complications after HBV vaccination are extremely rare, regardless of the type of vaccine used.

A short-term reaction of the body (redness, thickening, increased temperature) passes very quickly and without consequences.