Vaccination against viral hepatitis

Vaccines are available against Hepatitis B and also Hepatitis A. There are two hepatitis B vaccine available, a genetically engineered vaccine, and plasma derived vaccine. Plasma derived vaccine is inexpensive and immunogenic. Any plasma-derived vaccine,

however safe, will always be under scrutiny in view of non-detectable potential particles or proteins that may cause conditions like BSE.

The genetically engineered vaccine

is safe with equal immunogenicity and is expensive. WHO recommends either plasma derived or the genetically engineered vaccine for mass immunization. Many countries have adopted Hepatitis B vaccination for mass immunization as part of their routine immunization schedule for all children. A knowledge of the prevalence of the Hepatitis B carrier state in a population should form the basis for recommending mass immunization. In India, the carrier state ranges between 3% and 7% which makes vaccination necessary.

Since a sizeable number of infections may occur perinatally, and also because of the chance of the chance of such infection leading to a state and serious debilitating liver disease, it is logical that immunization be started at the earliest, that is, in the neonatal period.

What is the dose of vaccine is a gray area. Currently, it is recommended that children less than 10 years be given 10 micrograms and persons above be given 20 micrograms. The necessity for a booster dose 5 or 10 years later is a matter of subjective wisdom. Whether hepatitis surface antigen alone is sufficient to elicit complete protection or the vaccine should contain all the antigenic components of Hepatitis B virus is a matter for further study and elucidation.

Vaccination against HBV necessary in India

Neonatal vaccination recommended