Vaccination, vaccine and booster
To prevent infection with a hepatitis B virus, the permanent vaccination commission (STIKO) recommends multiple active vaccinations against the hepatitis B virus. The vaccine consists of a protein substance (HbsAG), which is genetically engineered from brewer’s yeast and enriched with aluminium compounds to improve the active control of the virus by the own body (immune response). Additionally, the vaccine contains some stabilizing components (antibiotics, formaldehyde or phenoxyethanol).
The vaccination is usually administered into the muscle (intramuscular) of the upper arm (deltoid muscle) or in children into the thigh muscle. The body is immunized here by the fact that the vaccine contains a substance that is very similar to a surface structure of the hepatitis B virus (Hbs antigen). As a result, the body learns to recognize this structure (and also to recognize it again in the event of a proper infection) and to take action against it.
This is done by forming interceptor particles (antibodies) that can bind to the corresponding surface structure.Armed with this knowledge of the surface structure and the associated trapping particle, the body can then successfully ward off hepatitis B infections in the future. The standard vaccination should be given to all children in the form of 3 vaccinations (basic immunizations) after birth (week 0), at the age of 1 month and 6 -12 months after the first vaccination. Approximately 2 – 6 weeks after the 3rd vaccination, protection against the hepatitis B virus begins and lasts for about 10 years.
After 10 years it is recommended to determine the number of existing defence molecules (anti-Hbs) in the blood and to carry out a booster vaccination depending on the value (with a vaccination titre < 100 I. U.). In addition, adults who have an increased risk of infection with the hepatitis B virus, whether at work or not (e.g. health care workers), should ensure that there is a sufficient amount of virus-fighting defence molecules in the blood (virus titre) and undergo a booster vaccination if necessary.
Likewise, immunocompromised persons (e.g. dialysis patients) should have regular blood tests (titer checks) and, in the case of an anti-Hbs value < 100 I. E.l., receive a booster vaccination. If a possible infection occurs, e.g. through a needle-stick injury or mucous membrane contact with a person infected with hepatitis B, the permanent vaccination commission (STIKO) recommends so-called post-exposure prophylaxis. This should be carried out as soon as possible (< 6 hours after contact) in the form of a so-called active and passive simultaneous vaccination.
This means that both defensive substances (antibodies), which fight the virus immediately but do not form a memory (passive vaccination), and virus components (antigens) for the formation of the body’s own defence molecules (active vaccination) are vaccinated simultaneously at different sites (e.g. different upper arms). Likewise, infants of hepatitis B infected mothers should receive such post-exposure prophylaxis within 12 hours after birth. Side effects that can occur with a hepatitis B vaccination are temporary skin reactions (redness, pain, swelling, swelling of the lymph nodes) in the area of the vaccination, allergic reactions, gastrointestinal complaints, headaches, aching limbs and fever.
In the case of more severe side effects of the vaccination, such as allergic reactions, a doctor should be consulted who can assess the severity of the reaction and plan further action. Pregnant women and nursing mothers should not be vaccinated due to possible developmental disorders. In addition, a vaccination must be carefully weighed out and vaccination sequences observed in persons who are intolerant to components of the vaccine.
andIn general, if the HBs antigen titer is sufficient, the risk of infection is reduced to a minimum after 3 vaccinations as part of the basic immunization. It should be noted, however, that not all people respond equally well to the hepatitis B vaccine. There are patients who generate no or only a very low immune response, they are called non-responders or low-responders.
In such patients, more vaccinations than usual must be given to ensure adequate protection. However, these persons are not always filtered out by a blood test to check the success of the vaccination (titer determination). In this case there is a risk that these people – despite formally sufficient vaccination – will develop hepatitis B. For this reason, the Standing Vaccination Commission (STIKO) of the Robert Koch Institute recommends checking the success of the vaccination by means of titer determination after 4-8 weeks for all indication groups (patients with weakened immune systems, occupationally exposed persons, contact persons, travel to certain countries).
