Hep B Blog
Hepatitis B Diagnosis & Monitoring, Hepatitis B Treatment, Liver Cancer, Living with Hepatitis B

Celebrating the Holidays with Hepatitis B

Image courtesy of Pixabay

The holidays are a joyous time as family and friends gather for parties, dinners and get-togethers. However, they can also be a difficult, stressful time on so many levels, and especially for those who might not yet have disclosed their hepatitis B to loved ones.  You may have been recently diagnosed, or decided this is the year you’re going to let them know about your status. If you’re not there yet, that’s okay, but consider making this the year you choose to disclose.

Enjoy and celebrate the holiday cheer, but …alcoholic beverages may be an issue during this time, and it may be tempting to indulge. The most important thing to do is not pick up that drink no matter what! Hepatitis B and alcohol is a dangerous combination. Here are some tips that may help you politely refuse a drink:

  • Practice saying no
  • Prepare a reason for not drinking (i.e., “Sorry, I’m taking mediation and I can’t drink.” or “My stomach is upset and I want to enjoy all this food.”)
  • Leave the event early if you feel uncomfortable.
  • Find others who are not drinking.
  • Choose a non-alcoholic drink – sparkling water with fruit is a healthy option!
  • Volunteer to be the designated driver. You may suddenly find you have many friends!

You might want to think long and hard about disclosing your status to coworkers and acquaintances.  Only you know for sure, but family and close friends can become a new source of support for you moving forward. If the holidays inspire you to share your status, you may start with talking about your family’s health history. Even though hepatitis B is not genetic and does not run in families like some other chronic diseases, it is possible that you may have hepatitis B because you were exposed to it from an infected family member, possibly at birth or by accidental household exposure; 90% of babies and 50% of young children who were infected with hepatitis B become chronically infected. It is also important to talk about hepatitis B if there is a history of liver disease and cancer in your family. Having hepatitis B can put you at an increased risk of developing liver disease and liver cancer during your lifetime.

Here are some other considerations:

  • Choose a time when there will not be too many distractions.
  • Think about whether your loved ones will be open and accepting.
  • Bring up an interesting fact to open up the conversation.
  • Ask a relative about their health history.
  • Try to break stereotypes surrounding hepatitis B.
  • Encourage your family members to get tested, vaccinated, or treated.
  • Family members may mention that “an uncle had liver problems”, or “died of cancer”, but not know if it was related to hepatitis B.
  • Be prepared with a printed fact sheet or video from the Hepatitis B Foundation or material from the Know Hepatitis B campaign!

Disclosure can be scary and make you anxious! When you are disclosing to a loved one, their response is out of your control, but their response might surprise you. Be prepared with simple explanations about hepatitis B. A Google search may highlight frightening statistics, so be sure to reassure loved ones that HBV is controllable and manageable.

Take a look at the videos from our #justB storytellers about how HBV has impacted their lives, and share them with family members. We must all do what we can to break the silence about hepatitis B so we can get more people tested and into care, and reduce stigma and discrimination!

For more tips on how to navigate the holidays with hepatitis B, check out our previous post here.

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Living with Hepatitis B

It’s Flu Season! Did you get your shot?

Flu season is upon us! It usually ranges from the winter into early spring. It’s important that you get your flu shot, especially if you or a family member has a chronic disease such as hepatitis B.

The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older get the flu vaccine every year. Flu viruses change constantly from season to season and can even mutate during a single flu season. It takes 2 weeks for antibodies to develop, so get your flu shot today!

There are some people who cannot get the flu shot, including certain age groups, those with health complications, and those with allergies. However, there are still ways people can protect against getting sick. Be sure to wash your hands to prevent the spread of germs. If you feel you are sick, stay home from work or school.

While we all know antiviral drugs are effective against the hepatitis B virus, researchers have also developed antivirals that can help us fight the flu once it is confirmed someone are infected. People at high risk of serious flu complications (such as children younger than 2 years, adults 65 and older, pregnant women, and people with chronic hepatitis B) and people who simply get very sick with the flu should talk to their doctor about getting one of three available flu antiviral drugs–oseltamivir, zanamivir, or peramivir.

According to CDC, prompt treatment with a flu antiviral can mean the difference between having a mild case versus a very serious one that can potentially land you in the hospital.

Treatment with antivirals works best when begun within 48 hours of getting sick, but can still help if administered later during your illness. Antivirals are effective in all age and risk groups. Studies show some doctors do not prescribe antiviral drugs to people at high risk of complications from the flu, so be assertive and ask your doctor for them if you have the flu!

It’s time to get your flu shot! It will help you, your family, and friends get protected against the flu. To find out where you can get a flu shot, click here.

For more information about hepatitis B and the flu vaccine, check out our previous posts on the flu here, here, and here.

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Living with Hepatitis B

HIV/HBV Co-Infection

World AIDS Day was last Friday, December 1st. It is a day dedicated to raising awareness about HIV and AIDS. However, it is also a great opportunity to discuss the possibility of coinfection with hepatitis B virus, HBV.

 Dr. John Ward, MD, Director, Division of Viral Hepatitis, CDC talks about hepatitis B, hepatitis C, and HIV epidemics in the United States.

Hepatitis B (HBV) and HIV/AIDs have similar modes of transmission. They can be transmitted through direct contact with blood, or sexual transmission (both heterosexual and MSM). Unfortunately, people who are high risk for HIV are also at risk for HBV, though hepatitis B is 50-100 times more infectious than HIV. Fortunately hepatitis B is a vaccine preventable disease and the vaccine is recommended for individuals living with chronic HIV.

Nearly one third of people who are infected with HIV are also infected with hepatitis B or hepatitis C (HCV).2 To break down the numbers further, about 10% of people with HIV also have hepatitis B, and about  25% of people with HIV also have hepatitis C.2 Liver complications due to HBV and HCV infections have become the most common non-AIDS-related cause of death for people who are HIV-positive.3

Who is at risk of HIV and HBV co-infection? Because both infections have similar transmission routes, injection drug use and unprotected sex (sex without condoms) are risk factors for both infections.4 However, there are additional risk factors for HIV and  for HBV that put people at risk4

It is important that people who are at risk of both diseases are tested! HIV-positive people who are exposed to HBV are more likely to develop a chronic HBV infection and other liver associated complications, such as liver-related morbidity and mortality if they are infected with HBV.1

If a person is co-infected with both HBV and HIV, management of both diseases can be complicated, so a visit to the appropriate specialists is vital.3 Some anti-retrovirals, which are usually prescribed to treat HIV, can eventually lead to antiviral resistance or liver-associated problems.3 One or both infections will require treatment and must be carefully managed.  Treatment differs from person to person .4

It is also important to hear about the perspectives of those who are living with co-infections. As a part of our #justB: Real People Sharing their Stories of Hepatitis B storytelling campaign, Jason shares his experience of living with both hepatitis B and HIV/AIDs.

To learn more about HIV and viral hepatitis coinfection, go here. For more #justB videos, go here.

References:

  1. Centers for Disease Control and Prevention (CDC). (2017, Sept). HIV/AIDS and Viral Hepatitis. Retrieved from: https://www.cdc.gov/hepatitis/populations/hiv.htm
  2. Centers for Disease Control and Prevention (CDC). (2017, June). HIV and Viral Hepatitis. Retrieved from: https://www.cdc.gov/hiv/pdf/library/factsheets/hiv-viral-hepatitis.pdf
  3. Weibaum, C.M., Williams, I., Mast, E.E., Wang, S.A., Finelli, L., Wasley, A., Neitzel, S.M, & Ward, J.W. (2008). Recommendations forMorbidity and Mortality Weekly Report (MMWR), 57(RR08), 1-20. Retrieved from: Identification and Public Health Management of Persons with Chronic Hepatitis B Infection. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5708a1.htm

Hepatitis B Prevention, Hepatitis B Treatment, Liver Cancer, News

Special Film Screening: “Hilleman: A Perilous Quest to Save the World’s Children”

The Hepatitis B Foundation was excited to share a special film screening of Hilleman: A Perilous Quest to Save the World’s Children.

Packed house at the film screening with opening remarks by Chari Cohen, DrPH, MPH

The documentary film, produced by The Vaccine Makers Project, follows the unknown story of a man who “had more of an impact on [people’s] lives compared to Einstein.” The film tells the story of a courageous and gutsy scientist, Dr. Maurice R. Hilleman, and the elimination of diseases of children. With his unwavering determination, Dr. Hilleman invented the first-ever vaccine against a human cancer (the hepatitis B vaccine), developed the measles-mumps-rubella (MMR) combination vaccine, and prevented pandemic flu. During World War II he developed an urgently needed vaccine for Japanese B encephalitis in 30 days.

 

The hepatitis B virus was also featured in the documentary.

He is responsible for more than half of the vaccines children receive today and is credited with saving more than eight million lives every year. Now through exclusive interviews with Dr. Hilleman and his peers, rare archival footage, and 3-D animation, this new documentary puts a human face to vaccine science, revealing the character that drove this bold, complex, and heroic man.

When parents began choosing not to vaccinate their children in the 1990s, a cruel irony became clear; Hilleman’s unprecedented successes have allowed us to forget just how devastating childhood diseases can be. The documentary reminds us by allowing us to see these diseases as part of the film.

Chari Cohen, DrPH, MPH introducing the panelists. L-R: Timothy Block, PhD (Moderator), Donald Rayne Mitchell, David Oshinsky, PhD, Walter Tsou , MD, MPH, Paul Offit, MD

Community members from Philadelphia and Bucks County came for the film screening as they enjoyed fun movie snacks. They also enjoyed a panel discussion moderated by Timothy Block, PhD, with the documentary director and esteemed representatives from scientific community. Expert panelists included Donald Rayne Mitchell, Paul Offit, MD, David Oshinsky, PhD, and Walter Tsou, MD, MPH. They shared their thoughts on the documentary, Dr. Hilleman’s life, and the future of vaccines. Mitchell and Dr. Offit expressed that the documentary film was created to “inspire a kid or to get into [scientific] work someday,” and to “put a human face on vaccines.”

For more information about the film, click here. If you are interested in learning more about the hepatitis B vaccine, click here.

Be on the look out for a special “preview” vlog of the film screening at the end of December 2017.

Hepatitis B Advocacy, Hepatitis B Prevention

Vlog: A Day in the Life of a Public Health Coordinator

Join Kristine Alarcon, MPH for A Day in the Life of a Public Health Coordinator to learn about some of the activities we at the Hepatitis B Foundation take part in!

In this vlog, Kristine and her colleagues participate in an Asian American Pacific Islander Town Hall to voice their concerns about hepatitis B in the Philadelphia community. They also attend the 2017 Philadelphia Asian American Film Festival for a screening of the Hepatitis B Foundation‘s #justB storytelling campaign.

 

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Liver Cancer, Living with Hepatitis B, Uncategorized

Sharing Your Story – Your Family’s Story

Sharing Your Story – Your Family’s Story

Image courtesy of Good Free Photos

Thanksgiving is not only a day to eat turkey or remind us to remember what we are thankful for; it is also National Family History Day!!1 This holiday can be used an opportunity for families to discuss and record health problems that run through the family, as this helps us live longer and healthier. 1

There are many chronic diseases that may run through multiple generations of a family. 1 Doctors can predict whether or not you could have a chronic disease just by knowing if your parents, grandparents, and other relatives have had it. 1 That is why knowing your family health history is an important and powerful screening tool.1 You can change unhealthy behaviors, reduce your risk of diseases, and know when you should be screened when you learn about what diseases run through your family. 2

Image courtesy of Wikimedia Commons

Hepatitis B is not like other chronic diseases, where if your parents have it, your genes make you more prone to it. Hepatitis B is not genetic. The hepatitis B virus is transmitted through blood and infected body fluids. This can happen through direct blood-to-blood contact, unprotected sex, body piercings or tattooing, intravenous drug use, and as a result of unsafe medical or dental procedures. It can also be transmitted from an hepatitis B positive mother to her baby at birth.

Even though hepatitis B is not genetic, you should still include it in your family health history discussion! The most common method of hepatitis B transmission worldwide is from mother-to-child due to the blood exchange that happens during child birth. Pregnant women who are infected with hepatitis B can transmit the virus to their newborns during delivery. 90% of babies exposed to hepatitis B at birth will become chronically infected with hepatitis B, which increases their risk of serious liver disease later in life. Knowing your family’s hepatitis B history can help you figure out if you and other loved ones should get screened for or vaccinated to protect against hepatitis B.

Image courtesy of Wikimedia Commons

Knowing if you have a family history of liver cancer can also be important, since hepatitis B is one of the leading causes of liver cancer. If your family has a history of hepatitis B related liver cancer, then you may have a greater risk of developing liver damage or liver cancer if you have hepatitis B. Be sure to discuss a family history of liver cancer with your liver specialist.

If you need some advice on how to start the conversation about your family health history, read more here. You can also use the US Department of Health & Human Services’s My Family Health Portrait Web tool to help start this dialogue and learn how to share family history information at a future doctor visit.

You don’t need to wait until this Thanksgiving to talk about your family health history. You can talk to your family about your family health history and hepatitis B status RIGHT NOW!

References:

  1. https://www.hhs.gov/programs/prevention-and-wellness/family-health-history/about-family-health-history/index.html
  2. https://www.cdc.gov/genomics/famhistory/famhist_basics.htm

 

 

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Living with Hepatitis B

Diagnosing Hepatitis D in the U.S.

Robert Gish, MD

David Hillyard, MD

By Sierra Pellechio, Hepatitis Delta Connect Coordinator

Hepatitis D, or hepatitis delta, is the most severe form of viral hepatitis known to humans. The hepatitis D virus infects the liver and is dependent on the hepatitis B virus to reproduce. This means that people who are already infected with hepatitis B are at risk of contracting hepatitis D as well.

Worldwide, more than 257 million people live with hepatitis B and of this number, an estimated 15-20 million are also infected with the hepatitis delta virus (HDV). While uncommon in the United States, HDV co-infection is more common in parts of the world such as China, Russia, Middle East, Mongolia, Romania, Georgia, Turkey, Pakistan, Africa, and the Amazonian river basin. For this reason, it is important to test hepatitis B patients who originate from these higher endemic areas for hepatitis D. Anyone with chronic hepatitis B who is not responding to antiviral treatment, or who has signs of liver damage even though they have a low viral load (HBV DNA below 2,000 IU/mL) should also be tested. Fatty liver disease (caused by obesity) and liver damage from alcohol or environmental toxins should be ruled out as causes of liver damage before testing for HDV.  Hepatitis D infections lead to more serious liver disease than hepatitis B infection alone. It is associated with faster progression to liver fibrosis, increased risk of liver cancer, and early decompensated cirrhosis and liver failure. This is why it is so important that people with hepatitis B and D coinfection are diagnosed before it can lead to severe complications.

Robert Gish, MD, Hepatitis B Foundation Medical Director, and David Hillyard, MD, Medical Director, Molecular Infectious Diseases, ARUP Laboratories, tackled the topic of diagnosing hepatitis D in a webinar in October. Dr. Gish also answered additional questions, which are featured below:

  • What is the first step in diagnosing an HDV patient?

The HDV antibody test (anti-HDV) is the first test that is run to see if a patient has been infected with hepatitis delta. Because this test will be positive even if a patient has cleared a hepatitis delta infection, it is followed up with an HDV RNA test, which determines an active infection. There is also an antibody test (anti-HDV igM) that can test for an acute active infection.

  • Are there tests available in the US that can detect the HDV genotypes or just genotype I?

Although there have been 8 genotypes of HDV identified, each with their own distinct progression outcomes, genotype testing in the US remains rare and often difficult to acquire.

  • What is the role of measuring HDV RNA in monitoring chronic HDV progression or response to treatment?

The most effective way to understand the progression of a hepatitis D infection is to use liver ultrasounds, elastrography and fibroscans. These tests can evaluate the health of the liver. Declining HDV RNA level usually indicates a positive response to treatment.

  • Is there value to testing patients for a disease for which there are not many treatments?

Because patients who are coinfected with B and D have twice the risk of cirrhosis and liver cancer compared to monoinfected patients, it is an important diagnosis to make. Although there is currently only 1 treatment, lives are still being saved.

  • Should primary care providers be testing high-risk patients for HBV and HDV at the same time?

No, providers should only test patients who already have hepatitis B. One in twenty people with hepatitis B are thought to also be infected with hepatitis D. Bottom line: testing for hepatitis D is a simple blood test that could change the course of treatment and save your patient’s life!

If you do find out that you have hepatitis D, it can be overwhelming and scary. However, knowing the basics can help you manage your diagnosis. Through the Hepatitis B Foundation’s Hep Delta Connect program, you can get information on how to protect your loved ones, find a physician, and seek out support.

For more information, please click here or visit our Hepatitis Delta Connect program website. Please also contact Sierra Pellechio, the Program Manager for Hepatitis Delta Connect program at sierra.pellechio@hepb.org for any questions.

Uncategorized

World Immunization Day! Hepatitis B Vaccine

While World Immunization Week takes place during April, World Immunization Day is TODAY, November 10th! The World Health Organization (WHO) established the day to raise awareness for vaccines as a cost effective and low-tech method of preventing illness and disease.

Worldwide 84% of countries have hepatitis B immunization programs; yet only 39% provide the necessary birth dose to prevent hepatitis B. This is a huge gap that must be addressed if we are to meet hepatitis elimination goals by 2030.

To celebrate World Immunization Day, here are some facts about the hepatitis B vaccine!

The safe and effective vaccine provides lifetime protection against hepatitis B, the most serious common liver infection in the world.  The vaccine is a series of 3 shots given over a 6-month period, typically at 0, 1 and 6 months.

There are minimum time periods that are needed between each dose. The second dose is given at least 4 weeks after the first dose; the third dose is given at least 8 weeks after the second dose, and there must be at least 16 weeks between doses 1 and 3.

After the 1st dose of HBV vaccine, there can be up to 50% protection. After the 2nd dose of HBV vaccine, there can be up to 80% protection.  It is very important to receive the third shot to ensure maximum, long-term protection.

If your vaccine schedule has been delayed, you do not need to start the series over, you can continue from where you have left off – even if there have been years between doses.

CDC, AAP and WHO recommend the birth dose for ALL newborns within 24 hours of birth because newborns and babies are at the greatest risk of developing lifelong, chronic infection if they are exposed to the hepatitis B virus. Giving the “birth dose” of the hepatitis B vaccine after a baby is born helps to reduce the risk of transmission to this very vulnerable population.

Perinatal prevention is especially critical for babies born to women who are infected with hepatitis B. All pregnant women should be screened for HBV. If positive, mom should be referred to care, and her baby should receive the birth dose of the vaccine and shot of hepatitis B immune globulin (HBIG), if available, within 12 hours of birth.

In order to meet this requirement, the first dose of the hepatitis B vaccine must be the “monovalent vaccine,” which means it is only the hepatitis B vaccine.

Many countries provide the “pentavalent vaccine”, which protects against 5 diseases, including hepatitis B. Unfortunately, the first dose of the “pentavalent vaccine” is given at 6 weeks, which means babies are not protected at birth and during the first 6 weeks of life against the hepatitis B virus.

It is very important that babies receive the “monovalent” hepatitis B vaccine at birth (not the “pentavalent vaccine”) in order to protect against a lifelong chronic hepatitis B infection. Babies must complete the vaccine series according to schedule. This can be done singly with the HBV monovalent vaccination or in combination with other vaccines (pentavalent, hexavalent etc.) Babies born to mothers that are hepatitis B positive should follow up with post-serologic testing at 9 months or a year to ensure the baby is protected against the hepatitis B virus.

There is no second chance to protect a newborn or baby from hepatitis B!

If a child, adolescent or adult missed the hepatitis B vaccine, they can be vaccinated at any time. For adults, it is never too late to start the hepatitis B vaccine (unless you are already infected with the hepatitis B virus, or have recovered from a past infection).

For more information on hepatitis B vaccine in babies or children, consult the “Summary of Recommendations for Child/Teen Immunization.” For more information on hepatitis B vaccine in adults, consult CDC’s Recommended Adult Immunization Schedule.

Be sure to talk to your doctor about getting the hepatitis B vaccine (if you have not already). Not only does it protect against hepatitis B, but also hepatitis D and help prevent liver cancer!

References:

https://medgenomelabs.wordpress.com/2015/11/10/world-immunization-day/

Hepatitis B Diagnosis & Monitoring, Hepatitis B Treatment, Living with Hepatitis B

Navigating Our Emotions When We’re First Diagnosed with Hepatitis B

Image courtesy of Pixabay

When we’re first diagnosed with hepatitis B, our physical health isn’t the only thing we need to focus on. Many of us experience powerful surges of fear, anger, sadness, powerlessness, depression, and anxiety.

No matter what you’re feeling, you have a right to feel whatever emotions are welling up – sometimes unexpectedly – inside you. There are no right or wrong feelings, they just are, and it’s up to you to decide what choices you make and how to respond to them.

When my daughter was first diagnosed, she was a toddler and happened to be coming down with a cold. I knew nothing about hepatitis B and was convinced she would soon die from it given her crankiness, lethargy, and nonstop sleeping.

Within a day or two, she was her smiling, energetic self again, and I happily slipped into denial. Surely the test was wrong or there was a mix-up in the result. My husband dragged his feet for weeks before he agreed to be screened for hepatitis B so great was his denial and fear.

Denial is a normal first reaction, it can give us some  breathing room to get used to the idea that we’re infected. But denial can also be dangerous, especially if we’re in a sexual relationship with someone and don’t take precautions. Denial can be dangerous when we hide our infection and don’t tell our family members or partners, even though they may have been exposed. Denial is dangerous when we don’t tell our parents, who may not know they’re infected and unknowingly passed the virus to us at birth.

It’s important to talk out our feelings with a doctor, a therapist, or a friend you trust. We need to move through denial so we can begin to receive the care and support we need, and talk to others who may also be at risk.

Anger is another common and natural feeling after a diagnosis. It’s OK to get upset about how we or our family members were infected, or get angry that our parents or lovers didn’t know they had the virus and infected us. Try to talk about your anger with counselors or friends, get some exercise to work off your tension and avoid situations—including drugs or alcohol—that can ignite festering emotions.

It’s normal to feel sad, and sometimes the sadness doesn’t go away quickly. If you feel prolonged sadness, anxiety, or fear, or find you’re gaining or losing weight or sleeping more or less than usual, it’s time to talk to someone who can help.

Fear and anxiety are common because we don’t know what’s going to happen next. If you’ve just been diagnosed, you may have to wait six months for another test to show whether you were recently infected and have acute (short-term) or were infected as a child and have chronic (long-term) hepatitis B. That wait can be insufferable.

Our stress can cause a host of physical symptoms, ranging from headaches to fatigue, that may have nothing to do with hepatitis B. It’s important to talk to your doctor about these symptoms so you know what is hepatitis B-related, and what’s caused by worry and fears.

At this early stage, many of us want to get rid of the virus as soon as possible and we’re willing to try any supplement or treatment available, even if our doctors tell us we’re healthy and don’t need any treatment. At this early diagnosis point, we just need to take care of ourselves, eat healthy foods, avoid alcohol and cigarettes, and get monitored regularly, even though what we really want is a magic pill that will make this infection go away.

In normal grief cycles, there is a point of acceptance. But I’m not sure we totally ever accept this loss of our “perfect” health, and our ability to have sexual relations, give birth, or drink a glass of wine without thinking of the shadow hepatitis B casts over these activities.

As a wise friend has pointed out, we need to accept that hepatitis B is part of us, but it doesn’t have to define us. Perhaps getting to that realization is the journey we begin when we read that first lab report and hear the diagnosis.

For support and information from other people living with hepatitis B, join the Hepatitis B Information and Support Email List at  http://hblist.net

Hepatitis B Prevention

The 3-Shot Hepatitis B Vaccine – Do I Need to Restart the Series if I Am Off the Recommended Schedule?

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The Hepatitis B vaccine is a safe and effective 3-shot series that protects against the hepatitis B virus.  If you do not have a current hepatitis B infection, or have not recovered from a past infection, then hepatitis B vaccination is an important way to protect yourself. The recommended schedule for the hepatitis B vaccine is to receive the first shot, followed in one month by the second shot.  Six months following the first shot, you should receive your third and final shot of the series.

If you wish to ensure you have generated adequate immunity, and are protected, you can have your anti-HBs (HBsAb) titres checked 4-8 weeks following the last shot of the hepatitis B vaccine series.  If your titer is greater than 10 mIU/mL, then you have adequate immunity which is thought to confer lifetime immunity, but studies so far show 30 years.  This is because these studies are on-going!

Please note that checking anti-HBs titres is not generally recommended for all vaccine recipients, with the exception of those that are at greater risk of infection.   This includes but is not limited to health care workers, those with sexual partners with hepatitis B, and those living in a household where someone is infected. Talk to your doctor if you think you might be at higher risk and need to have your titres checked.

So what happens if you go for shot one, followed by shot two in a month, but you never get to shot three?  The minimum length of time between the three shots in the series is 0, 1 month, and 6 months.  This is the schedule recommended for the shortest amount of time, with the best immune response for the general population.  However, if you don’t get to shot three of the series for another two years, or if you never got to shot two, you can resume right from where you left off, and continue without the need for repeating the series. Just remember that you are not fully protected until you have completed the series.

Here is a rule to remember the minimum time in between shots in the series:

Dose 2 should be separated by dose 1 by at least one month (4 weeks or 28 days)

Dose 3 should be separated by dose 2 by at least 2 months (8 weeks) AND from dose 1 by at least 4 months (16 weeks).

Keep in mind that the goal is to get people protected in the shortest amount of time, with the fewest number of doses. If you do not complete the series, you will not have adequate, longterm protection from hepatitis B.

What happens if you don’t have your vaccine records, and you have no idea if you ever got shot 1 or 2, and you just want to repeat the series? There is no concern with repeating the HBV vaccine series, so if you are unsure, please start the series from shot 1.

What about an accelerated schedule? Generally doctors advise against an accelerated schedule since it requires a 4th dose in order to provide long term protection. It’s hard enough to get people to adhere to the 3-shot schedule. Planning for a 4th dose in a year is a challenge.

What happens if you are pregnant; is it safe to get vaccinated? Absolutely yes!

What do you do while you’re waiting to complete the series? Be sure to take basic precautions avoiding direct contact with infected blood and practice safe sex.

Be sure you and your loved ones vaccinated are against hepatitis B so you can be hepatitis B free for life!

Baruch S. Blumberg Institute