SlideShare a Scribd company logo
Vaccines  D-r Mitova MU-Sofia
Hepatitis B and Hepatitis B vaccine ,[object Object],[object Object],[object Object],[object Object]
Hepatitis B Virus ,[object Object],[object Object],[object Object],[object Object]
Hepatitis B Virus Infection ,[object Object],[object Object],[object Object]
HBsAg HBcAg HBeAg Hepatitis B Virus
Hepatitis B Clinical Features ,[object Object],[object Object],[object Object],[object Object]
Symptoms HBeAg anti-HBe Total anti-HBc IgM anti-HBc anti-HBs HBsAg 0 4 8 12 16 20 24 28 32 36 52 100 Acute Hepatitis B Virus Infection with Recovery Typical Serologic Course Weeks after Exposure Titre
Hepatitis B Complications ,[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic Hepatitis B  Virus Infection ,[object Object],[object Object],[object Object],[object Object]
[object Object]
Hepatitis B Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hepatitis B Perinatal Transmission  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*in the absence of postexposure prophylaxis
Global Patterns of Chronic HBV Infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Age of Infection of Acute and Chronic Hepatitis B Virus Infection Acute infection Chronic infection CDC Sentinel Sites.
[object Object],CDC Sentinel Sites.  2001 data.
Hepatitis B Virus Infection by Duration of High-Risk Behavior 0 3 6 9 12 15 Years at Risk 0 20 40 60 80 100 Percent  infected IV drug user Homosexual men HCWs Heterosexual
Strategy to Eliminate Hepatitis B Virus Transmission  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hepatitis B Vaccine 1965 Discovery of Australian antigen 1973 Successful HBV infection of chimpanzees 1981 Licensure of plasma-derived vaccine 1986 Licensure of recombinant vaccine 1991 Universal infant vaccination 1996 Universal adolescent vaccination
Hepatitis B Vaccine ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hepatitis B Vaccine Formulations ,[object Object],[object Object]
Protection* by Age Group and Dose * Anti-HBs antibody titer of   10 mIU/mL or higher ** Preterm infants less than 2 kg have been shown to respond to vaccination less often *** Factors that may lower vaccine response rates are age >40 years, male gender, smoking, obesity, and immune deficiency 90%-95% 98%-100% 3 75%-80% 80%-95% 2 20%-30% 16%-40% 1 Teens and Adults*** Infants** Dose
[object Object],Infants and children <11 years of age Adolescents 11-19 years Adults  > 20 years (16) Recombivax HB Dose (mcg) 0.5 mL (5) 0.5 mL (5) 1.0 mL (10) Engerix-B Dose (mcg) 0.5 mL (10) 0.5 mL (10) 1.0 mL (20)
Hepatitis B Vaccine.Long-term Efficacy ,[object Object],[object Object],[object Object]
[object Object],Routine booster doses are  NOT  routinely recommended for any group
[object Object],Year 1981 1991 1995 Recommendation  Persons at high risk All infants Adolescents
Indications for  Hepatitis B Vaccine ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Usual Age 0 months  1 months 6 months Minimum Interval - - - 4 weeks 8 weeks* Hepatitis B Vaccine Routine Infant Schedule *and at least 16 weeks after the first dose
Very Low Birthweight Infants ,[object Object],[object Object],[object Object]
Pediarix ,[object Object],[object Object],[object Object],[object Object]
Pediarix ,[object Object],[object Object],[object Object]
Hepatitis B Vaccine Adolescent Vaccination ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Minimum Interval - - -  4 weeks 8 weeks* Usual Interval --- 1 month 5 months Hepatitis B Vaccine Adolescent and Adult Schedule *third dose must be separated from first dose by at least 16 weeks
Adult Hepatitis B  Vaccine Candidates ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Adult Hepatitis B  Vaccine Candidates ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*from countries of high or intermediate HBV endemnicity
Prevaccination Serologic Testing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Postvaccination Serologic Testing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Postvaccination Serologic Testing ,[object Object]
Management of Nonresponse to Hepatitis B Vaccine ,[object Object],[object Object],[object Object]
Persistent Nonresponse to Hepatitis B Vaccine ,[object Object],[object Object],[object Object],[object Object]
Prevention of Perinatal Hepatitis B Virus Infection ,[object Object],[object Object],[object Object],[object Object]
Twinrix ,[object Object],[object Object],[object Object]
Hepatitis B Vaccine Adverse Reactions ,[object Object],[object Object],[object Object],[object Object],Adults 13%-29% 11%-17% 1% rare Infants and  Children 3%-9% 0%-20% 0.4%-6% rare
Hepatitis B Vaccine Contraindications and Precautions ,[object Object],[object Object]
Tuberculosis ,[object Object],[object Object],[object Object]
Persons at Risk for Developing TB Disease ,[object Object],[object Object],Persons at high risk for developing TB disease fall into 2 categories
 
[object Object]
BCG Contraindications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
After having the injection, it is normal to develop a red lump over the injection site.
It is not necessary to cover the site with a bandage unless it oozes
This may increase in size for a few weeks before settling down into a scab.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Testing for  M. tuberculosis   Mantoux tuberculin skin test (TST) Skin test that produces delayed-type hypersensitivity reaction in persons with  M. tuberculosis  infection
Administering the TST ,[object Object],[object Object]
Reading the TST (1) ,[object Object],[object Object],[object Object],[object Object]
TST Interpretation (1) ,[object Object],[object Object],[object Object],[object Object]
TST Interpretation (2) ,[object Object],[object Object],[object Object]
TST Interpretation (3) ,[object Object],[object Object],[object Object],[object Object],[object Object]
TST Interpretation (4) ,[object Object],[object Object],[object Object]
TST Interpretation (5) ,[object Object],*Although skin testing programs should be conducted only among high-risk groups, certain individuals may require TST for employment or school attendance. Diagnosis and treatment of LTBI should always be tied to risk assessment. 15-mm induration is interpreted as positive in ____________________________________________________
Factors That May Cause False-Positive TST Reactions ,[object Object],[object Object],[object Object],[object Object]
Factors That May Cause False-Negative TST Reactions (1)  ,[object Object],[object Object],[object Object]
Factors That May Cause False-Negative TST Reactions (2)  ,[object Object],[object Object],[object Object],[object Object]
Factors That May Cause False-Negative TST Reactions (3) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DTaP Vaccination   Pertussis ,[object Object],[object Object],[object Object],[object Object]
Whole-Cell Pertussis Vaccine ,[object Object],[object Object],[object Object],[object Object]
Acellular Pertussis Vaccine (DTaP) ,[object Object],[object Object],[object Object],[object Object]
Diphtheria ,[object Object],[object Object],[object Object],[object Object],[object Object]
Corynebacterium  diphtheriae ,[object Object],[object Object],[object Object]
Tetanus ,[object Object],[object Object],[object Object],[object Object]
Clostridium  tetani ,[object Object],[object Object],[object Object],[object Object]
Tetanus Clinical Features ,[object Object],[object Object],[object Object],[object Object]
Neonatal Tetanus ,[object Object],[object Object],[object Object],[object Object]
Tetanus Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tetanus Epidemiology ,[object Object],[object Object],[object Object],[object Object]
Tetanus Toxoid ,[object Object],[object Object],[object Object],[object Object],[object Object]
Routine DTaP Primary Vaccination Schedule (Pentaxim in Bulgaria) Dose Primary 1 Primary 2 Primary 3 Primary 4 Age 2 months 3 months 4 months 16-24 months Interval   --- 4 wks 4 wks 6 mos
[object Object],[object Object],[object Object],[object Object],Booster Doses
Routine Td Schedule Unvaccinated Persons  > 7 Years of Age Booster dose every 10 years Dose Primary 1 Primary 2 Primary 3 Interval --- 4 wks 6-12 mos
Diphtheria and Tetanus Toxoids Adverse Reactions ,[object Object],[object Object],[object Object],[object Object]
Diphtheria and Tetanus Toxoids Contraindications and Precautions ,[object Object],[object Object]
DTaP Adverse Reactions ,[object Object],[object Object],[object Object],[object Object]
Adverse Reactions Following the 4th and 5th DTaP Dose ,[object Object],[object Object],[object Object]
DTaP Contraindications ,[object Object],[object Object]
DTaP Precautions ,[object Object],[object Object],[object Object],[object Object],[object Object],*may consider use in outbreaks
Pertussis Vaccine Use in Children with Underlying Neurologic Disorders Underlying Condition Prior seizure Suspected neurologic disorder Neurologic event between doses Stable/resolved neurologic condition Recommendation Delay and assess* Delay and assess* Delay and assess* Vaccinate * vaccinate after treatment initiated and condition stabilized
Tetanus Wound Management * Yes, if >10 years since last dose ** Yes, if >5 years since last dose Vaccination History Unknown or <3 doses 3+ doses Td TIG Yes No No* No Td TIG Yes Yes No** No Clean, minor wounds All other wounds

More Related Content

What's hot

Prophylactic immunization based on medical science
Prophylactic immunization based on medical scienceProphylactic immunization based on medical science
Prophylactic immunization based on medical science
KAVIN6369950450
 

What's hot (20)

Viral vaccines, An introduction
Viral vaccines, An introduction Viral vaccines, An introduction
Viral vaccines, An introduction
 
Haemophilus influenzae
Haemophilus influenzaeHaemophilus influenzae
Haemophilus influenzae
 
Viral hepatitis 6
Viral hepatitis 6Viral hepatitis 6
Viral hepatitis 6
 
Lab diagnosis of syphilis
Lab diagnosis of syphilisLab diagnosis of syphilis
Lab diagnosis of syphilis
 
vaccination
vaccinationvaccination
vaccination
 
Hepatitis B virus
Hepatitis B  virusHepatitis B  virus
Hepatitis B virus
 
Vaccination and Immunization
Vaccination and ImmunizationVaccination and Immunization
Vaccination and Immunization
 
Polio vaccine
Polio vaccinePolio vaccine
Polio vaccine
 
Complement fixation tests
Complement fixation testsComplement fixation tests
Complement fixation tests
 
BCG ,DPT ,OPV
BCG ,DPT ,OPVBCG ,DPT ,OPV
BCG ,DPT ,OPV
 
E coli
E coliE coli
E coli
 
Hcv
HcvHcv
Hcv
 
General properties of viruses
General properties of virusesGeneral properties of viruses
General properties of viruses
 
Rabies vaccines
Rabies vaccinesRabies vaccines
Rabies vaccines
 
Hepatitis ppt final
Hepatitis ppt finalHepatitis ppt final
Hepatitis ppt final
 
Widal
WidalWidal
Widal
 
Hepatitis virus
Hepatitis virusHepatitis virus
Hepatitis virus
 
Viral vaccines
Viral vaccinesViral vaccines
Viral vaccines
 
Prophylactic immunization based on medical science
Prophylactic immunization based on medical scienceProphylactic immunization based on medical science
Prophylactic immunization based on medical science
 
Laboratory diagnosis of salmonella
Laboratory diagnosis of salmonellaLaboratory diagnosis of salmonella
Laboratory diagnosis of salmonella
 

Viewers also liked

Vaccine of hepatitis E virus
Vaccine of hepatitis E virusVaccine of hepatitis E virus
Vaccine of hepatitis E virus
Samir Haffar
 
L29 hepatocellular carcinoma
L29 hepatocellular carcinomaL29 hepatocellular carcinoma
L29 hepatocellular carcinoma
Mohammad Manzoor
 
MMR Slide Show (Final)
MMR Slide Show (Final)MMR Slide Show (Final)
MMR Slide Show (Final)
comotrekker
 

Viewers also liked (20)

Hep B8p
Hep B8pHep B8p
Hep B8p
 
Hepatitis B Vaccine revisited - Ideal Schedule & recommendations
Hepatitis B Vaccine revisited - Ideal Schedule & recommendationsHepatitis B Vaccine revisited - Ideal Schedule & recommendations
Hepatitis B Vaccine revisited - Ideal Schedule & recommendations
 
Vaccine of hepatitis E virus
Vaccine of hepatitis E virusVaccine of hepatitis E virus
Vaccine of hepatitis E virus
 
HiBand Hep B
HiBand Hep B HiBand Hep B
HiBand Hep B
 
Edible vaccines
Edible vaccinesEdible vaccines
Edible vaccines
 
NUCs in Chronic Hepatitis B
NUCs in Chronic Hepatitis BNUCs in Chronic Hepatitis B
NUCs in Chronic Hepatitis B
 
Hepatitis B
Hepatitis BHepatitis B
Hepatitis B
 
L29 hepatocellular carcinoma
L29 hepatocellular carcinomaL29 hepatocellular carcinoma
L29 hepatocellular carcinoma
 
Vax 2 A
Vax 2 AVax 2 A
Vax 2 A
 
Complications of Liver Disease (Academic Day Seminar)
Complications of Liver Disease (Academic Day Seminar)Complications of Liver Disease (Academic Day Seminar)
Complications of Liver Disease (Academic Day Seminar)
 
VACCINATIONS IN PREGNANCY BY DR SHASHWAT JANI
VACCINATIONS IN PREGNANCY BY DR SHASHWAT JANIVACCINATIONS IN PREGNANCY BY DR SHASHWAT JANI
VACCINATIONS IN PREGNANCY BY DR SHASHWAT JANI
 
Hepatitis b package final
Hepatitis b package finalHepatitis b package final
Hepatitis b package final
 
Lecture 8 the cardiovascular system blood vessels and circulation
Lecture 8 the cardiovascular system blood vessels and circulationLecture 8 the cardiovascular system blood vessels and circulation
Lecture 8 the cardiovascular system blood vessels and circulation
 
Liver function test
Liver function testLiver function test
Liver function test
 
Conventional methods of animal vaccine production
Conventional methods of animal vaccine productionConventional methods of animal vaccine production
Conventional methods of animal vaccine production
 
Hepatitis b
Hepatitis bHepatitis b
Hepatitis b
 
MMR Slide Show (Final)
MMR Slide Show (Final)MMR Slide Show (Final)
MMR Slide Show (Final)
 
Acute Liver Failure
Acute Liver Failure Acute Liver Failure
Acute Liver Failure
 
Dental Patients with Liver Disease
Dental Patients with Liver DiseaseDental Patients with Liver Disease
Dental Patients with Liver Disease
 
Liver anatomy
Liver anatomyLiver anatomy
Liver anatomy
 

Similar to Vaccine2 hep b

Management of hbv exposed infants
Management of hbv exposed infantsManagement of hbv exposed infants
Management of hbv exposed infants
Hassan Kamil S O
 
preventionHepatitis B Sokhna.ppt
preventionHepatitis B Sokhna.pptpreventionHepatitis B Sokhna.ppt
preventionHepatitis B Sokhna.ppt
Mlelo79
 
EPIDEMIOLOGY OF HEPATITIS B AND C
EPIDEMIOLOGY OF HEPATITIS B AND CEPIDEMIOLOGY OF HEPATITIS B AND C
EPIDEMIOLOGY OF HEPATITIS B AND C
Soumya Sahoo
 

Similar to Vaccine2 hep b (20)

Management of hbv exposed infants
Management of hbv exposed infantsManagement of hbv exposed infants
Management of hbv exposed infants
 
Adultvaccinationy 121010201616-phpapp02
Adultvaccinationy 121010201616-phpapp02Adultvaccinationy 121010201616-phpapp02
Adultvaccinationy 121010201616-phpapp02
 
Malman
MalmanMalman
Malman
 
Hepatitis B virus infection
Hepatitis B virus infectionHepatitis B virus infection
Hepatitis B virus infection
 
preventionHepatitis B Sokhna.ppt
preventionHepatitis B Sokhna.pptpreventionHepatitis B Sokhna.ppt
preventionHepatitis B Sokhna.ppt
 
Hepatitis b vaccination
Hepatitis b vaccinationHepatitis b vaccination
Hepatitis b vaccination
 
EPIDEMIOLOGY OF HEPATITIS B AND C
EPIDEMIOLOGY OF HEPATITIS B AND CEPIDEMIOLOGY OF HEPATITIS B AND C
EPIDEMIOLOGY OF HEPATITIS B AND C
 
Adult vaccination part 1
Adult vaccination part 1Adult vaccination part 1
Adult vaccination part 1
 
Viral hepatitis class.pptx
Viral hepatitis class.pptxViral hepatitis class.pptx
Viral hepatitis class.pptx
 
35. hepatitis
35. hepatitis35. hepatitis
35. hepatitis
 
Adult vaccination
Adult vaccinationAdult vaccination
Adult vaccination
 
Viral hepatitis (Inflammation of liver)
Viral hepatitis (Inflammation of liver)Viral hepatitis (Inflammation of liver)
Viral hepatitis (Inflammation of liver)
 
Hepatitis b disease surveilance :epidemiology:school of public health: univer...
Hepatitis b disease surveilance :epidemiology:school of public health: univer...Hepatitis b disease surveilance :epidemiology:school of public health: univer...
Hepatitis b disease surveilance :epidemiology:school of public health: univer...
 
VIRAL HEPATITIS by NOM KUMAR NAIK
VIRAL HEPATITIS  by NOM KUMAR NAIKVIRAL HEPATITIS  by NOM KUMAR NAIK
VIRAL HEPATITIS by NOM KUMAR NAIK
 
Pediatric HIV.pdf
Pediatric HIV.pdfPediatric HIV.pdf
Pediatric HIV.pdf
 
Adult immunisation.pptx
Adult immunisation.pptxAdult immunisation.pptx
Adult immunisation.pptx
 
Current managent of hepatitis B - Session 1
Current managent of hepatitis B - Session 1Current managent of hepatitis B - Session 1
Current managent of hepatitis B - Session 1
 
‎Untitled.pptx
‎Untitled.pptx‎Untitled.pptx
‎Untitled.pptx
 
Hepatitis B In children by Dr. kaniz fathema, resident, paediatric Gastroente...
Hepatitis B In children by Dr. kaniz fathema, resident, paediatric Gastroente...Hepatitis B In children by Dr. kaniz fathema, resident, paediatric Gastroente...
Hepatitis B In children by Dr. kaniz fathema, resident, paediatric Gastroente...
 
05 -immunization_2
05  -immunization_205  -immunization_2
05 -immunization_2
 

More from Jasmine John

Seminar noise vibr infra ultra
Seminar noise vibr infra ultraSeminar noise vibr infra ultra
Seminar noise vibr infra ultra
Jasmine John
 
Physiological and psychophysical methods
Physiological and psychophysical methodsPhysiological and psychophysical methods
Physiological and psychophysical methods
Jasmine John
 
Occupational health and ergonomics
Occupational health and ergonomicsOccupational health and ergonomics
Occupational health and ergonomics
Jasmine John
 
Infrasoundultrasound
Infrasoundultrasound Infrasoundultrasound
Infrasoundultrasound
Jasmine John
 
Industrial toxicology
Industrial toxicologyIndustrial toxicology
Industrial toxicology
Jasmine John
 
Industrial hygiene № 28
Industrial hygiene № 28Industrial hygiene № 28
Industrial hygiene № 28
Jasmine John
 
Ind hygiene № 27
Ind hygiene № 27Ind hygiene № 27
Ind hygiene № 27
Jasmine John
 
Climate weather physical factors
Climate  weather physical factorsClimate  weather physical factors
Climate weather physical factors
Jasmine John
 
Antropogenic air pollution
Antropogenic air pollutionAntropogenic air pollution
Antropogenic air pollution
Jasmine John
 
Agriculture lecture
Agriculture lectureAgriculture lecture
Agriculture lecture
Jasmine John
 
24 noise vibration and occupational medicine
24   noise vibration and  occupational medicine24   noise vibration and  occupational medicine
24 noise vibration and occupational medicine
Jasmine John
 
Comfort in buildings
Comfort in buildingsComfort in buildings
Comfort in buildings
Jasmine John
 
Let talk about home, hosing and buildings
Let talk about home, hosing and buildingsLet talk about home, hosing and buildings
Let talk about home, hosing and buildings
Jasmine John
 

More from Jasmine John (20)

Seminar noise vibr infra ultra
Seminar noise vibr infra ultraSeminar noise vibr infra ultra
Seminar noise vibr infra ultra
 
Thermal comfort
Thermal comfortThermal comfort
Thermal comfort
 
Work physiology
Work physiologyWork physiology
Work physiology
 
Physiological and psychophysical methods
Physiological and psychophysical methodsPhysiological and psychophysical methods
Physiological and psychophysical methods
 
Pesricides
PesricidesPesricides
Pesricides
 
Occupational health and ergonomics
Occupational health and ergonomicsOccupational health and ergonomics
Occupational health and ergonomics
 
Noise
NoiseNoise
Noise
 
Infrasoundultrasound
Infrasoundultrasound Infrasoundultrasound
Infrasoundultrasound
 
Industrial toxicology
Industrial toxicologyIndustrial toxicology
Industrial toxicology
 
Industrial hygiene № 28
Industrial hygiene № 28Industrial hygiene № 28
Industrial hygiene № 28
 
Ind hygiene № 27
Ind hygiene № 27Ind hygiene № 27
Ind hygiene № 27
 
Ergonomics
ErgonomicsErgonomics
Ergonomics
 
Climate weather physical factors
Climate  weather physical factorsClimate  weather physical factors
Climate weather physical factors
 
Antropogenic air pollution
Antropogenic air pollutionAntropogenic air pollution
Antropogenic air pollution
 
Agriculture lecture
Agriculture lectureAgriculture lecture
Agriculture lecture
 
24 noise vibration and occupational medicine
24   noise vibration and  occupational medicine24   noise vibration and  occupational medicine
24 noise vibration and occupational medicine
 
Vibration
VibrationVibration
Vibration
 
Home
HomeHome
Home
 
Comfort in buildings
Comfort in buildingsComfort in buildings
Comfort in buildings
 
Let talk about home, hosing and buildings
Let talk about home, hosing and buildingsLet talk about home, hosing and buildings
Let talk about home, hosing and buildings
 

Recently uploaded

Cardiac Impulse: Rhythmical Excitation and Conduction in the Heart
Cardiac Impulse: Rhythmical Excitation and Conduction in the HeartCardiac Impulse: Rhythmical Excitation and Conduction in the Heart
Cardiac Impulse: Rhythmical Excitation and Conduction in the Heart
MedicoseAcademics
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Dr Jeenal Mistry
 

Recently uploaded (20)

Non-Invasive assessment of arterial stiffness in advanced heart failure patie...
Non-Invasive assessment of arterial stiffness in advanced heart failure patie...Non-Invasive assessment of arterial stiffness in advanced heart failure patie...
Non-Invasive assessment of arterial stiffness in advanced heart failure patie...
 
In-service education (Nursing Mangement)
In-service education (Nursing Mangement)In-service education (Nursing Mangement)
In-service education (Nursing Mangement)
 
Final CAPNOCYTOPHAGA INFECTION by Gauri Gawande.pptx
Final CAPNOCYTOPHAGA INFECTION by Gauri Gawande.pptxFinal CAPNOCYTOPHAGA INFECTION by Gauri Gawande.pptx
Final CAPNOCYTOPHAGA INFECTION by Gauri Gawande.pptx
 
Introducing VarSeq Dx as a Medical Device in the European Union
Introducing VarSeq Dx as a Medical Device in the European UnionIntroducing VarSeq Dx as a Medical Device in the European Union
Introducing VarSeq Dx as a Medical Device in the European Union
 
Antiplatelets in IHD, Dose Duration, DAPT vs SAPT
Antiplatelets in IHD, Dose Duration, DAPT vs SAPTAntiplatelets in IHD, Dose Duration, DAPT vs SAPT
Antiplatelets in IHD, Dose Duration, DAPT vs SAPT
 
Cardiac Impulse: Rhythmical Excitation and Conduction in the Heart
Cardiac Impulse: Rhythmical Excitation and Conduction in the HeartCardiac Impulse: Rhythmical Excitation and Conduction in the Heart
Cardiac Impulse: Rhythmical Excitation and Conduction in the Heart
 
Prix Galien International 2024 Forum Program
Prix Galien International 2024 Forum ProgramPrix Galien International 2024 Forum Program
Prix Galien International 2024 Forum Program
 
Gauri Gawande(9) Constipation Final.pptx
Gauri Gawande(9) Constipation Final.pptxGauri Gawande(9) Constipation Final.pptx
Gauri Gawande(9) Constipation Final.pptx
 
5cl adbb 5cladba cheap and fine Telegram: +85297504341
5cl adbb 5cladba cheap and fine Telegram: +852975043415cl adbb 5cladba cheap and fine Telegram: +85297504341
5cl adbb 5cladba cheap and fine Telegram: +85297504341
 
Book Trailer: PGMEE in a Nutshell (CEE MD/MS PG Entrance Examination)
Book Trailer: PGMEE in a Nutshell (CEE MD/MS PG Entrance Examination)Book Trailer: PGMEE in a Nutshell (CEE MD/MS PG Entrance Examination)
Book Trailer: PGMEE in a Nutshell (CEE MD/MS PG Entrance Examination)
 
TEST BANK For Williams' Essentials of Nutrition and Diet Therapy, 13th Editio...
TEST BANK For Williams' Essentials of Nutrition and Diet Therapy, 13th Editio...TEST BANK For Williams' Essentials of Nutrition and Diet Therapy, 13th Editio...
TEST BANK For Williams' Essentials of Nutrition and Diet Therapy, 13th Editio...
 
Factors Affecting child behavior in Pediatric Dentistry
Factors Affecting child behavior in Pediatric DentistryFactors Affecting child behavior in Pediatric Dentistry
Factors Affecting child behavior in Pediatric Dentistry
 
linearity concept of significance, standard deviation, chi square test, stude...
linearity concept of significance, standard deviation, chi square test, stude...linearity concept of significance, standard deviation, chi square test, stude...
linearity concept of significance, standard deviation, chi square test, stude...
 
Impact of cancers therapies on the loss in cardiac function, myocardial fffic...
Impact of cancers therapies on the loss in cardiac function, myocardial fffic...Impact of cancers therapies on the loss in cardiac function, myocardial fffic...
Impact of cancers therapies on the loss in cardiac function, myocardial fffic...
 
End Feel -joint end feel - Normal and Abnormal end feel
End Feel -joint end feel - Normal and Abnormal end feelEnd Feel -joint end feel - Normal and Abnormal end feel
End Feel -joint end feel - Normal and Abnormal end feel
 
CURRENT HEALTH PROBLEMS AND ITS SOLUTION BY AYURVEDA.pptx
CURRENT HEALTH PROBLEMS AND ITS SOLUTION BY AYURVEDA.pptxCURRENT HEALTH PROBLEMS AND ITS SOLUTION BY AYURVEDA.pptx
CURRENT HEALTH PROBLEMS AND ITS SOLUTION BY AYURVEDA.pptx
 
Aptopadesha Pramana / Pariksha: The Verbal Testimony
Aptopadesha Pramana / Pariksha: The Verbal TestimonyAptopadesha Pramana / Pariksha: The Verbal Testimony
Aptopadesha Pramana / Pariksha: The Verbal Testimony
 
Creating Accessible Public Health Communications
Creating Accessible Public Health CommunicationsCreating Accessible Public Health Communications
Creating Accessible Public Health Communications
 
1130525--家醫計畫2.0糖尿病照護研討會-社團法人高雄市醫師公會.pdf
1130525--家醫計畫2.0糖尿病照護研討會-社團法人高雄市醫師公會.pdf1130525--家醫計畫2.0糖尿病照護研討會-社團法人高雄市醫師公會.pdf
1130525--家醫計畫2.0糖尿病照護研討會-社團法人高雄市醫師公會.pdf
 
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
 

Vaccine2 hep b

  • 1. Vaccines D-r Mitova MU-Sofia
  • 2.
  • 3.
  • 4.
  • 5. HBsAg HBcAg HBeAg Hepatitis B Virus
  • 6.
  • 7. Symptoms HBeAg anti-HBe Total anti-HBc IgM anti-HBc anti-HBs HBsAg 0 4 8 12 16 20 24 28 32 36 52 100 Acute Hepatitis B Virus Infection with Recovery Typical Serologic Course Weeks after Exposure Titre
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.  
  • 15. Age of Infection of Acute and Chronic Hepatitis B Virus Infection Acute infection Chronic infection CDC Sentinel Sites.
  • 16.
  • 17. Hepatitis B Virus Infection by Duration of High-Risk Behavior 0 3 6 9 12 15 Years at Risk 0 20 40 60 80 100 Percent infected IV drug user Homosexual men HCWs Heterosexual
  • 18.
  • 19. Hepatitis B Vaccine 1965 Discovery of Australian antigen 1973 Successful HBV infection of chimpanzees 1981 Licensure of plasma-derived vaccine 1986 Licensure of recombinant vaccine 1991 Universal infant vaccination 1996 Universal adolescent vaccination
  • 20.
  • 21.
  • 22. Protection* by Age Group and Dose * Anti-HBs antibody titer of 10 mIU/mL or higher ** Preterm infants less than 2 kg have been shown to respond to vaccination less often *** Factors that may lower vaccine response rates are age >40 years, male gender, smoking, obesity, and immune deficiency 90%-95% 98%-100% 3 75%-80% 80%-95% 2 20%-30% 16%-40% 1 Teens and Adults*** Infants** Dose
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.  
  • 48.
  • 49.
  • 50.  
  • 51. After having the injection, it is normal to develop a red lump over the injection site.
  • 52. It is not necessary to cover the site with a bandage unless it oozes
  • 53. This may increase in size for a few weeks before settling down into a scab.
  • 54.
  • 55. Testing for M. tuberculosis Mantoux tuberculin skin test (TST) Skin test that produces delayed-type hypersensitivity reaction in persons with M. tuberculosis infection
  • 56.
  • 57.
  • 58.
  • 59.
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 65.
  • 66.
  • 67.
  • 68.
  • 69.
  • 70.
  • 71.
  • 72.
  • 73.
  • 74.
  • 75.
  • 76.
  • 77.
  • 78.
  • 79. Routine DTaP Primary Vaccination Schedule (Pentaxim in Bulgaria) Dose Primary 1 Primary 2 Primary 3 Primary 4 Age 2 months 3 months 4 months 16-24 months Interval --- 4 wks 4 wks 6 mos
  • 80.
  • 81. Routine Td Schedule Unvaccinated Persons > 7 Years of Age Booster dose every 10 years Dose Primary 1 Primary 2 Primary 3 Interval --- 4 wks 6-12 mos
  • 82.
  • 83.
  • 84.
  • 85.
  • 86.
  • 87.
  • 88. Pertussis Vaccine Use in Children with Underlying Neurologic Disorders Underlying Condition Prior seizure Suspected neurologic disorder Neurologic event between doses Stable/resolved neurologic condition Recommendation Delay and assess* Delay and assess* Delay and assess* Vaccinate * vaccinate after treatment initiated and condition stabilized
  • 89. Tetanus Wound Management * Yes, if >10 years since last dose ** Yes, if >5 years since last dose Vaccination History Unknown or <3 doses 3+ doses Td TIG Yes No No* No Td TIG Yes Yes No** No Clean, minor wounds All other wounds

Editor's Notes

  1. Although HBV has numerous antigens, only the presence of HBsAg indicates active infection. Antibody to HBsAg, from either disease or vaccine, indicates immunity.
  2. 35
  3. This graphic shows the distribution of risk factors in 2001. Persons with multiple sexual contacts, men who have sex with men, and sexual contact with a person known to have HBV infection account for 54 percent of cases with a known risk factor. Injection drug use accounts for 20 percent of cases. About 3 percent of cases are in people who have household contact with a person with acute or chronic hepatitis B. Fifteen years ago, health care workers accounted for 2 percent of HBV infections- 2 or 3 thousand new infections each year. Since that time, the rate of infection among health care workers has declined by 95 percent, and is now lower than the rate for the general population. Hepatitis B vaccine has made occupational HBV infection a thing of the past.
  4. 5 5 5
  5. In December 2002, the US Food and Drug Administration approved a new combination vaccine- Pediarix- which is manufactured by Glaxo Smith Kline. This vaccine contains DTaP, inactivated polio and hepatitis B vaccines. The DTaP component is Infanrix, and the hepatitis B component is Engerix-B, which were previously licensed in the U.S. Pediarix is approved for the first three doses of the DTAP and IPV series, which are usually given at about 2, 4, and 6 months of age. However, Pediarix is approved for use through 6 years of age. The minimum age for the first dose of Pediarix is 6 weeks. So it can’t be used for the birth dose of the hepatitis B series.
  6. Interchangeable Can be used after a birth dose of heaptitis B – total of 4 doses O.K. Pediarix may be used in infants born to women who are hepatitis B surface antigen positive or whose hepatitis B status is unknown. Like COMVAX, Pediarix is not approved for this use. But at it’s February 2003 meeting, ACIP voted to allow the use of Pediarix to complete the hepatitis B series in these infants. But remember that the minimum age for Pediarix is 6 weeks, so it must NOT be used for the birth or one month dose of the hepatitis B series. Another important fact to remember about Pediarix is that the minimum intervals between doses are dictated by the single antigen with the longest minimum intervals. Therefore, Pediarix minimum intervals are determined by the hepatitis B component. As for hepatitis B vaccine, the minimum interval between the first two doses of Pediarix is 4 weeks. The third dose must be administered at least 8 weeks after the second dose, and should follow the first dose by at least 16 weeks. The third dose should not be given before 6 months of age to be counted as a valid third dose of hepatitis B vaccine.