How Well do You Know – Hepatitis A and B Immunization?

February 3, 2020

Hepatitis A and B Immunization

I present quite often on travel medicine.  I commonly get questions from healthcare professionals on hepatitis A and hepatitis B immunization. The Canadian Immunization Guide does a great review in their:

Interactive Hep A and Hep B Quiz (17 T/F Questions)

1. Approximately 25% of adult cases of hepatitis A are hospitalized

2. Chronic hepatitis and carrier states is common with both hepatitis A and hepatitis B

3. If a traveller requires both hepatitis A and B injection, and are travelling 40 days from today, they should receive two doses of Twinrix prior to travel.

4. Protection from hepatitis A likely will persist for at least 20 years, possibly life, even when antibodies are no longer measurable

5. If a patient has had hepatitis B vaccine series 13 years ago, she should get a booster dose prior to her next trip.

6. Hepatitis A and B virus are primarily transmitted through contaminated bodily fluid.

7. If a brand of hepatitis A vaccine is on back order, you can give another brand of hepatitis A vaccine for the booster dose.

8. Initial infection with hepatitis B may be asymptomatic in up to 50% of adults and 90% of children.

9. Individuals with chronic kidney disease require a double dose of hepatitis B vaccine to provide protection

10. If a patient has received 2 doses of Twinrix(R) prior to a trip 15 years ago.  She is going for another trip this year.  She would need only 1 booster dose.

11. If a traveller is a candidate for hepatitis A and hepatitis B vaccines and is travelling in less than 21 days, monovalent hepatitis A and hepatitis B vaccines should be administered separately.

12. If there is a hepatitis A outbreak, you can immunize up to 3 days after exposure and receive 50% protection.

13. Hepatitis A vaccine can be administered up to the day of travel departure and the person will be protected for his/her trip.

14. Hepatitis A vaccine is recommended for travellers to most countries of the world

15. A 33 year old patient is planning overseas travel.  They were up-to-date with all vaccines a child.  Prior to travel they would likely need only hepatitis A vaccine.

16. The three-dose hepatitis B vaccine schedule is 95% to 100% effective in preventing chronic infection for at least 30 years following immunization.  The duration of protection for the two-dose schedule is unknown.

17. Hepatitis A vaccines are at least 90% to 97% effective in preventing clinical hepatitis A illness.


 

References:

Public Health Agency of Canada Government of Canada. “Hepatitis A Vaccine – Part 4 – Active Vaccines – Canadian Immunization Guide – Public Health Agency of Canada.” http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-hepa-eng.php.
Public Health Agency of Canada. “Hepatitis B Vaccine – Part 4 – Active Vaccines – Canadian Immunization Guide – Public Health Agency of Canada,” March 2017. http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-hepb-eng.php.