Prevalence: Most acute hepatitis B (HB) cases in Canada occur in unimmunized adults, particularly through unprotected sexual activity and sharing injection drug equipment. A significant proportion of HB carriers are immigrants from HB-endemic areas.
Asymptomatic Cases: Up to 50% of adults and 90% of children with initial HB infection may be asymptomatic.
Chronic Carriers: Infants, young children, and immunocompromised persons are at the highest risk of becoming chronic HB carriers.
Vaccine Effectiveness: The HB vaccine is 95% to 100% effective pre-exposure.
Adverse Reactions: Generally mild and transient, including irritability, headache, fatigue, and local reactions at the injection site.
Recommendations for Use
Routine Immunization: Recommended for all children.
Pre-Exposure Immunization: Recommended for high-risk groups, including healthcare workers, people with certain medical conditions, and travelers to HB-endemic areas.
Post-Exposure Prophylaxis (PEP): Includes newborns of HB-infected mothers, individuals exposed to HB through blood or body fluids, and household or sexual contacts of acute or chronic HB cases.
Vaccination Schedules: Vary by province and territory; multiple vaccines and combination schedules are available.
Booster Doses: Generally not required for immunocompetent persons, but may be needed for immunocompromised individuals or those with chronic renal disease.
Pregnancy and Breastfeeding: Safe for use; immunization is recommended if at high risk.
Post-Immunization Serologic Testing: Recommended for high-risk groups to confirm adequate response.
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