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How effective is the Hepatitis B vaccine? If my wife is infected and I am vaccinated can I still get it?

Given the variables including but not only age, gender, health status, HLA (Human leukocyte antigen - Wikipedia) polymorphism, the fact that humans are an outbred species as compared to the inbred nature of most experimental animal models, and many others, no vaccine could give a 100% guarantee against future infection. This is especially so for an infection such as Hepatitis B virus (HBV), which can be transmitted not just sexually or through the bloodstream (injection drug use, transfusion) but also vertically from mother to child, an exposure route that entails profoundly different risk.A vaccine's track record can, however, give an estimate of risk of future infection. In that regard, cumulative data support long-term protection for immunocompetent individuals who have completed a HBV vaccine schedule (1).There are two ways to assess effectiveness of any vaccine,How effective it is in preventing getting infected, preexposure vaccine efficacy, andHow effective it is in preventing disease in those already infected, postexposure vaccine efficacy.The Hepatitis B vaccine - Wikipedia stimulates immune response against the HBsAg - Wikipedia (HBV surface antigen), specifically antibody responses to the 'a determinant' located between amino acids 100 to 160 of the HBsAg (2). Cumulative data show it to be capable of providing robust protection (3).Preexposure efficacy ranges from 80 to 100%.Postexposure efficacy ranges from from 85 to 95%.Circulating anti-HBs (anti-HBaAg) antibody concentrations of >/= 10 mIU/ml (mIU = milli International Unit, International unit - Wikipedia) is commonly considered protective, being empirically found to be important since anti-HBs antibody persistence, a measure of how long protection lasts, correlates with peak antibody level immediately post-vaccination (4).Typically, circulating levels of anti-HBs antibodies decline rapidly within the 1st year post-vaccination and more slowly from thereon, specifically, levels decline to <10 mIU/ml circulating anti-HBs antibody concentrations in ~ 7 to 50% within 5 years post-vaccination and in ~30 to 60% within 9 to 11 years post-vaccination (3).However, the critical issue for an infected person and their partner is duration of such protection and several studies that followed up for anywhere from 15 to 23 years found that declining circulating anti-HBs antibody levels aren't a concern since primary HBV vaccination can prevent infection for >20 years, regardless these levels (3).Robustness of HBV vaccine protection can be surmised from several studies around the world on populations ranging from infants to adolescents to young adults. In these studies, various groups who had been vaccinated, usually starting at birth, were re-vaccinated (booster dose).Since blood was pulled at the time of booster dose as well as 1 or more times afterwards, it was possible to compare post-boost circulating anti-HBs antibody response to the baseline pre-boost level (see table below from 1). Doing so showed that even as much as 15 to 23 years later, 62 to 76% of those previously vaccinated had a 4-fold increase in circulating anti-HBV antibody response 1, 2 or 4 weeks post-boost. This implies the HBV vaccine is capable of driving strong immune memory in diverse populations with different levels of exposure to the virus.However, strength of recall response against HBV is only one side of the equation. How effective is the HBV vaccine in preventing infection in someone already vaccinated?While HBV endemicity (Endemic (epidemiology) - Wikipedia) is different in different parts of the world, studies across regions with vastly varying endemicity show breakthrough infections, i.e., HBV infections in those previously vaccinated (see below from 1)Is low (1 to 13.8%) in the general population.Risk is higher (1.7 to 33.3%) among those born to carrier mothers.Clinically significant infections are few and far between even among those with breakthrough infections, meaning that prior vaccination substantially lowers disease risk even in those who do develop breakthrough infections.Risk for hepatocellular carcinoma is 70 to 80% lower among vaccinated and <50 years of age compared to historical controls (5).Bibliography1. Leuridan, Elke, and Pierre Van Damme. "Hepatitis B and the need for a booster dose." Clinical Infectious Diseases 53.1 (2011): 68-75. https://www.researchgate.net/profile/Pierre_Damme/publication/51201470_Hepatitis_B_and_the_Need_for_a_Booster_Dose/links/02bfe510d64a9cc0e9000000.pdf2. Coleman, Paul F. "Detecting hepatitis B surface antigen mutants." Emerging infectious diseases 12.2 (2006): 198. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293431/pdf/05-0038.pdf3. Van Damme, Pierre, et al. "Hepatitis B vaccines." Vaccines, 6th edn, Philadelphia, PA, USA: Elsevier (2012): 205-234.4. Floreani, Annarosa, et al. "Long-term persistence of anti-HBs after vaccination against HBV: an 18 year experience in health care workers." Vaccine 22.5 (2004): 607-610.5. Viviani, Simonetta, et al. "20 years into the Gambia Hepatitis Intervention Study: assessment of initial hypotheses and prospects for evaluation of protective effectiveness against liver cancer." Cancer Epidemiology and Prevention Biomarkers 17.11 (2008): 3216-3223. http://cebp.aacrjournals.org/content/17/11/3216.full-text.pdfThanks for the R2A, Still Working.

Is taking the hepatitis B vaccine twice risky?

No.To get full protective immunity you need to take 2 or 3 injections.If after that you lose your records and forget and you take the vaccine again it is no more than a waste of a few dollars. It will not harm you.That’s true with any vaccine. After initial immunity is formed, receiving an additional dose of the vaccine is not harmful. In some cases, it will strengthen the immunity. In that way the “clock” until you need a booster shot is reset. So if for example you take a tetanus shot ahead of schedule, that will extend your immunity for additional years. It is not harmful.

If we do not put the first shot of hepatitis B vaccine, can it start with a direct second shot?

Many immunisation records have the first dose of Hepatitis B vaccine shown at birth, and second at 6 weeks. However, this works only in institutions that give vaccines to babies.If the birth dose was not given in the maternity hospital, hepatitis B vaccine can be given at 6 weeks, and it will be counted as the first dose.The interval between the this (first) and the next (second) dose should be at least 4 weeks, and the interval between the first and the third dose should be at least 16 weeks.

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