Hepatitis B vaccine

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Virus-like particles of HBsAg

A hepatitis B vaccine is a vaccine against the hepatitis B virus . Vaccination against hepatitis B is recommended by the World Health Organization in all countries at birth.

properties

The first form of hepatitis B vaccine consisted of heat-inactivated hepatitis B viruses and was developed from 1969 by Baruch Blumberg and Irving Millman . Since the hepatitis B virus is an oncovirus , these hepatitis B vaccines were also the earliest approved form of a prophylactic cancer vaccine .

From 1981 inactivated virosomes isolated from the blood of HBV-positive donors were approved in the USA . This vaccine, named Heptavax, was developed in Maurice Hilleman's group and was the world's first approved subunit vaccine . It did not consist of complete viruses, but of individual proteins from the hepatitis B virus. The virus-like particles were inactivated, among other things, by adding pepsin for proteolysis and formaldehyde and urea for denaturation .

In 1986, the recombinant protein HBsAg was approved in the USA , which, due to its manufacture, has fewer possibilities of contamination and cannot contain hepatitis B viruses. This yeast-made vaccine was the world's first approved recombinant vaccine.

Hepatitis B vaccines are on the World Health Organization's list of Essential Medicines . They are also part of multiple vaccines in combination with hepatitis A vaccines. The World Health Organization recommends the use of hepatitis B vaccines in a quintuple vaccine with vaccines against diphtheria , tetanus , pertussis and Haemophilus influenzae b.

immunology

The vaccine is usually given three times in order to achieve the full vaccination effect. This produces neutralizing antibodies against HBsAg, which protect against infection with HBV. The success of the vaccination can be checked after one to four months by determining the anti-HBs titer . About 85 to 95% of those vaccinated develop immunity . A sufficient titer for hepatitis B vaccines is above 100 mIU / ml. If the antibody titer is below 100 mIU / ml (in the blood sample after the third vaccination dose), further vaccination doses should be administered. One speaks of so-called "low responders" (anti-Hbs 10 to 99 IU / l). Furthermore, after exposure to an anti-HBsAg antibody, immunization can be carried out passively .

Weak vaccine effects can occur if you are over 40 years of age, overweight and smoking . In addition, weak vaccination effects have been observed in alcoholism , immunosuppressed and dialysis patients.

People with anti-HBs levels below 10 IU / l after the primary vaccination course are considered " non-responders ". In this case, a determination of HBsAg and anti-HBc is recommended to rule out an existing chronic HBV infection.

Immunity lasts for about 25 years. Vaccination every five years is recommended in the UK for occupationally exposed persons.

Side effects

Adverse drug reactions with hepatitis B vaccines include pain at the injection site and one day flu-like symptoms.

Suspected connections between vaccinations with hepatitis B vaccines and multiple sclerosis could not be confirmed. Nonetheless, in 2017 the European Court of Justice allowed French courts to award the family of a French man who had previously received a hepatis B vaccination and who had previously received a hepatis B vaccination, compensation for alleged vaccine damage .

Trade names

Trade names for hepatitis B vaccines are e.g. B. Engerix B , Recombivax HB , Elovac B , Genevac B and Shanvac B . A trade name for hepatitis A and hepatitis B vaccines is Twinrix .

Individual evidence

  1. ↑ WHO: Hepatitis B vaccines: WHO position paper - July 2017 . Ed .: Weekly epidemiological record. No 27, 2017, 92, 369-392. http://apps.who.int/iris/bitstream/handle/10665/255841/WER9227.pdf;jsessionid=A244DC3A5D52C908D8D248F9C6849BEE?sequence=1 .
  2. ^ WHO Model Lists of Essential Medicines. (PDF) In: WHO. 2019, accessed April 4, 2020 .
  3. ↑ Jiri Beran: Bivalent inactivated hepatitis A and recombinant hepatitis B vaccine. In: Expert Review of Vaccines. 6, 2007, p. 891, doi : 10.1586 / 14760584.6.6.891 .
  4. ↑ Bar-On ES, Goldberg E, Hellmann S, Leibovici L: Combined DTP-HBV-HIB vaccine versus separately administered DTP-HBV and HIB vaccines for primary prevention of diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae B (HIB) . In: Cochrane Database Syst Rev . No. 4, 2012, p. CD005530. doi : 10.1002 / 14651858.CD005530.pub3 . PMID 22513932 .
  5. ↑ Gautam Sanyal, L. i. Shi: A review of multiple approaches towards an improved hepatitis B vaccine. In: Expert Opinion on Therapeutic Patents . 19, 2009, p. 59, doi : 10.1517 / 13543770802587226 .
  6. ↑ Joint Committee on Vaccination and Immunization: Chapter 12 immunization of healthcare and laboratory staff hepatitis B . In: Immunization Against Infectious Disease 2006 ("The Green Book") (), 3rd. Edition, Stationery Office, Edinburgh 2006, ISBN 0-11-322528-8 , p. 468. Archived from the original on January 7, 2013 Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . @1[{{{url}}} @ 2]Template: Webachiv / IABot /
  7. ↑ a b c d Joint Committee on Vaccination and Immunization: Chapter 18 Hepatitis B . In: Immunization Against Infectious Disease 2006 ("The Green Book") (), 3rd edition (Chapter 18 revised October 10, 2007). Edition, Stationery Office, Edinburgh 2006, ISBN 0-11-322528-8 , p. 468. Archived from the original on January 7, 2013 Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . @1[{{{url}}} @ 2]Template: Webachiv / IABot /
  8. ↑ a b RKI - RKI-Ratgeber - Hepatitis B and D. May 20, 2016, accessed on August 22, 2019 .
  9. ↑ AJ Roome: Hepatitis B vaccine responsiveness in Connecticut public safety personnel. In: JAMA 270, p. 2931, doi : 10.1001 / jama.270.24.2931 . PMID 8254852 .
  10. ↑ Alan S. Rosman, Prithwijit Basu, Kathryn Galvin, Charles S. Lieber: Efficacy of a High and Accelerated Dose of Hepatitis B Vaccine in Alcoholic Patients. In: The American Journal of Medicine. 103, 1997, p. 217, doi : 10.1016 / S0002-9343 (97) 00132-0 . PMID 9316554 .
  11. ↑ Pierre Van Damme, Koen Van Herck: A review of the long-term protection after hepatitis A and B vaccination. In: Travel Medicine and Infectious Disease. 5, 2007, p. 79, doi : 10.1016 / j.tmaid.2006.04.004 . PMID 17298912 .
  12. ↑ CDC - Hepatitis B and Multiple Sclerosis (MS) - Vaccine Safety . In: cdc.gov .
  13. ↑ ECJ judgment on vaccination: Vaccination damage recognized, without evidence , Die Zeit , June 27, 2017