Hepatitis - Hepatitis B and D

Hepatitis B vaccine protection lasts at least eight to 10 years. Booster shots after that may be recommended depending on continuing risk, such as sexual exposure. In fact, a 2002 study suggested that there is risk for infection in teenagers who were vaccinated in infancy, although protection against chronic hepatitis B may be maintained.

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The following adults are at very high risk and should be vaccinated:

Healthcare and public safety workers who may be exposed to blood products. Such individuals have a risk for hepatitis B virus that ranges from 15% to 30%.
People in the same household as HBV infected individuals. (Unvaccinated people who have had intimate exposure to people with HBV may be protected with immune globulin, which is sometimes administered with the vaccine.)
Travelers to developing countries.
Patients who require transfusions and have not been infected with HBV. (Those with blood clotting disorders should have the vaccination administered under the skin, not injected in the muscle.)
Sexually active homosexual or heterosexual individuals with multiple partners or who engage in high-risk sexual behavior.
People with any sexually transmitted diseases.

Other people at risk who would benefit from vaccinations are the following:

Patients and workers in mental institutions and morticians.
Patients on hemodialysis. (People on hemodialysis may need larger doses or boosters; they also may need to be re-vaccinated if blood tests indicate they are losing immunity.)
People who use injected drugs.
Pregnant women at risk for the virus should be vaccinated; there is no evidence that the vaccine is dangerous to the fetus.
People receiving treatments or who have conditions that suppress the immune system may need the vaccination, although its benefits for this group are unclear except for those at high risk, such as people with HIV or spleen abnormalities.

The regimen in adults is typically three doses given over six months. One study reported that older adults would benefit from a fourth dose without incurring serious side effects. People with alcoholism may need high doses.

A small percentage of people do not develop immunity even after a vaccine has been given repeatedly. A more potent vaccine is proving to be effective in these people; it loses its effect after five years in about a third of those who receive it.

Soreness at the injection site is the most common side effect. There have been some reports of nerve inflammation after vaccinations for hepatitis B, and there has been some concern about three small studies associating the vaccine with an insignificant increase in multiple sclerosis. Studies in 2001, however, have found no evidence to support these concerns. Nonetheless, some groups oppose the vaccination in children who are not in high-risk groups. It should be strongly stressed that worldwide 65 million people with chronic hepatitis are expected to die from liver disease. And, vaccinations are saving lives. For example, in Taiwan, where infection rates are high and infants are at risk for hepatitis B from infected mothers, vaccination programs have significantly reduced the risk for liver cancer.