Hepatitis B vaccine

Generic and proprietary names

– Engerix-B.

– HBvaxPro.

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– Combined hepatitis A and B vaccines.

Action

– Contains inactivated hepatitis B virus surface antigen and works by provoking the immune response.

Classification

– Vaccines and antisera.

Indications

– Those who may be exposed to blood or blood products at work such as health care workers.

– Abusers of injectable drugs.

– People with a number of sexual partners.

– Homosexual men.

– Haemodialysis patients or those receiving certain blood products.

– People with chronic liver disease or hepatitis C.

– People in close contact with a hepatitis B carrier or with an infected person.

– Staff and residents of homes.

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– Inmates and staff in prisons.

– Travellers intending to stay for long periods in areas where the hepatitis B incidence is high.

Contraindications

– Known hypersensitivity to any components of the vaccine, or to a previous dose.

– Acute febrile illness.

Interactions

– The immune response can be compromised by administration of high-dose steroids.

Side-effects

– Headache.

– Rash.

– Fatigue.

– Cold or flu-like symptoms.

– Fever (pyrexia).

– Pins and needles (paraesthesia).

– Dizziness.

– Pain in the joints (arthralgia).

– Pain in the muscles (myalgia).

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– Itching (pruritis).

– Soreness at injection site.

– Allergic reactions such as lips swelling, tongue and throat (angioedema) or narrowing of the airways (bronchospasm).

Administration

– Vaccination consists of a course of three injections over a three-month period.

– An accelerated schedule can be used where appropriate.

– It is good practice to continue a course with the same brand of vaccine. Vaccines may be used interchangeably if necessary.

– It is unnecessary to repeat doses if the course has been interrupted. Longer than recommended intervals between doses do not appear to reduce the final antibody level or efficacy.

– The deltoid muscle is the preferred injection site for adults and older children and the anterolateral thigh for neonates and young children. Use of the buttock reduces vaccine efficacy.

Nursing considerations

– Additional doses may be required for individuals with a suppressed immune system.

– Correct cold chain vaccine storage should be ensured.

– The injection site batch number and expiry date should be recorded in the patient record.

Patient teaching

– Hepatitis B vaccine does not protect against hepatitis caused by other agents or viruses.

– Universal precautions should always be maintained.

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines.

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