Mark B. Levin, M.D.
John M. Cotton, M.D.
Timothy J. Patrick-Miller, M.D.
Louis J. Tesoro, M.D.
Helen M. Rose, M.D.
The
Pediatric Group, P.A.
66 Mt. Lucas Road,
Princeton, NJ 08540-2733
Telephone 609-924-4892, Fax 609-921-9380
website: www.pedgroup.com
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We are happy to answer any general questions about medical topics and about ouor practice. We can answer specific questions only regarding patients who are currently enrolled in our practice. The material provided on this website is for informative purposes only. If you need specific advice, please contact your treating physician.
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January, 2001
Hepatitis B and Hepatitis B Vaccine
Disease considerations: This liver infection is usually acquired by contact with body fluids, such as blood and sexual secretions, and causes an acute febrile jaundice with loss of appetite, nausea, and malaise. Asymptomatic infection in infants and children is possible. It is more prolonged than Hepatitis A. Occasionally it can cause fulminant hepatitis and death. Chronic infection is possible in 90% of newborns and 6-10% of adults. 25% of chronically infected people will die of their disease. Hepatitis B is the most common identifiable cause of liver cancer. High risk behaviors for acquisition of this virus include sexual contact, especially with multiple partners and I.V. drug abuse. There is no curative treatment currently available for this infection.
Vaccine Considerations: This synthetic recombinant vaccine is given as 2 injections one month apart and a booster 4-17 months later (a schedule of 0, 1, 2 and 12 months may be followed for exposed neonates or if imminent and prolonged exposure is anticipated by virtue of travel, work or adoption). The vaccine confers immunity in nearly 100% of recipients under 10 years old; in 92-96% of recipients aged 20-39 years; and in 77% of those over 49 years old. This vaccine series is now routinely begun in infants under 2 months of age and is administered immediately after birth if intra-uterine exposure to Hepatitis B is suspected.
Duration of immunity: probably lifetime. Confirmatory
blood tests are generally not necessary except for those entering
medical professions.
Side effects: This vaccine is prepared by recombinant
technology and has no human or living components and no
preservative. Reactions include local soreness (22%), fatigue
(14%), fever/dizziness/headache (<10%), malaise/chills/upset
stomach, appetite loss/lymph gland inflammation/aches and
pains/rash/sleep disorder/low blood pressure (<1%), and rarely
hives, itching arthritis, skin bleeding, large coalescent hives,
optic neuritis, spinal cord inflammation, spinal cord paralysis,
low platelet counts, visual disturbances, hair loss and ringing
in the ears. Events listed as rare are not certain to be related
to the vaccine.
Our recommendations: Because of less side effects and the eventual need for protection from Hepatitis B, we recommend that infants be immunized routinely. For those children not immunized in infancy, the vaccine should be administered before adolescence. In New Jersey and many other states, Hepatitis B vaccine is now mandatory for school entry.
Let us know of any questions you may have regarding Hepatitis B vaccine.
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