HBV Immunisation Flashcards
HBsAg used as vaccine component
How is it produced?
Produced as recombinant in yeast
HBV infected healthcare worker performing EPP
What does viral load need to be below for EPP?
<200
If they have HBV DNA >200, they may be offered treatment with anti-virals ent/TAF/TDF,
even though they do not fit other criteria for treatment
HBV Immunisation
What is normal vaccination schedule?
What is accelerated vaccination schedule?
What is hyper-accelerated vaccination schedule?
Vaccine schedule can vary depending on brand of vaccine used
Normal -
0 days
1 month
6 months
Accelerated - 0 days 1 months 2 months 12 months - consider booster
Hyper-accelerated - 0 days 7 days 21 days 12 months - consider booster
HBV PEP
Significant exposure
Unvaccinated recipient
What is required in the following circumstances when exposed to these sources?
HBsAg pos
Unknown source
HBsAg neg
HBsAg pos - accelerated HBV vaccine + HBIG with first dose
Unknown source - accelerated HBV vaccine
HBsAg neg - consider course of HBV vaccine if ongoing risk
HBV PEP
Significant exposure
Partially vaccinated recipient
What is required in the following circumstances when exposed to these sources?
HBsAg pos
Unknown source
HBsAg neg
HBsAg pos - one dose of HBV vaccine, and finish course
Unknown source - one dose of HBV vaccine, and finish course
HBsAg neg - complete course of HBV vaccine
HBV PEP
Significant exposure
Fully vaccinated recipient
What is required in the following circumstances when exposed to these sources?
HBsAg pos
Unknown source
HBsAg neg
HBsAg pos - booster if last dose >1 year ago
Unknown source - booster if last dose >1 year ago
HBsAg neg - no vaccine required
HBV PEP
Significant exposure
Known non-responder to HBV - anti-HBs <10IU/ml 1-2 months post-immunisation
What is required in the following circumstances when exposed to these sources?
HBsAg pos
Unknown source
HBsAg neg
HBsAg pos - booster dose of HBV vaccine, HBIG plus second HBIG dose at 1 month. Also needs follow up bloods at 6 months for HBsAg check they have not acquired infection
Unknown source - booster dose of HBV vaccine, HBIG plus second HBIG dose at 1 month
HBsAg neg - no HBIG, consider course of HBV vaccine if ongoing risk
Staff has non-significant exposure to HBV
What action would you advise?
If ongoing risk - start HBV immunisation
If partially vaccinated - complete course of vaccine
If no ongoing risk - no need for HBV immunisation
