The lowdown on hepatitis vaccines, past and present
DEAR DR. ROACH: I have some questions about hepatitis vaccines. I live in Los Angeles, and have recently seen a few articles in the local paper about an outbreak of hepatitis A in the area. I went to my hospital and requested the hepatitis A vaccine. I was given the first of a two-shot vaccine, and was told to come back in six months for the second shot. I asked the nurse how long the vaccine would protect me after I took the second shot, and she didn’t know the answer to my question.
My next question involves the hepatitis B vaccine. In 1991, I was working in a Veterans Affairs hospital and took the three-shot series of the hepatitis B vaccine. When getting my hepatitis A shot, I asked if my hepatitis B vaccine was still good after 25 years. They drew blood to check titers. A week later, the hospital emailed me and said my titers were low and to come in for a booster shot, which I got. How come they didn’t just give me the three-shot series again instead of a booster shot? How many years will this hepatitis B booster shot protect me?
Are they working on a vaccine for hepatitis C? I eat out a lot, and restaurant employees may or may not practice good hygiene. A vaccine seems like a good precaution for people to take, in this day and age. What do you think? — D.A.S.
ANSWER: Hepatitis A vaccine is recommended for travelers to areas with high rates of hepatitis A. Two doses are administered, with the second dose given between six and 12 months after the first. Although we used to tell people that they needed a booster shot 10 years after the completed series, it appears that the protection from the vaccine is long-lasting, and a booster is not recommended.
For the current outbreak in San Diego, the Centers for Disease Control and Prevention recommends vaccination for homeless individuals; staff and public workers who have close contact with homeless or illicit drug users; and food handlers for adult populations. The rate of hepatitis A in the U.S. and Canada is small enough that I think it is not necessary for people with no particular risk factors to get it.
Hepatitis B vaccine is recommended for all adults. Ninetyfive per cent of people will have a good response, as measured by antibody levels in the blood (“titers”). Those with low titers are recommended to have a booster.
Most people are thought to have lifetime immunity after the vaccine. People with HIV infection and those on dialysis are exceptions and should have a booster.
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