Hepatitis B Vaccination

Hello

I reside in a country where Hepatitis B is a problem, before I left home I had the first vaccination, I was told I would need a booster 1 month after, and the final one six months later.

I really do not feel comfortable receiving this second vaccination in the country in which I reside. There is absolutely no drug regulation etc, so who knows what you are getting and even if it is a sterile vaccine.

1. If I waited until I return home which would be in February and received the second vaccination then would it be of any use?

2. Does the vaccination I received so far, without a booster, offer any protection.

3. I do not intend on being sexually active, could you get Hep B through social contact eg Sharing drinks, cigarettes, eating utensils etc. In instances where saliva and maybe a small amount of blood would be involved at worst case scenario.
I ask this because a friend of mine who is a doctor said you get it the same way as HIV but that it is about 1000 times more infectious. I know you cannot get HIV from the things I have listed above but does the increased infectious nature of HEP B change that?

Please answer the questions and advise on the risks I would be taking without receiving further vaccinations, considering I live in a country where it is a problem.

  

Best Regards
SM

[H. Hunter Handsfield, M.D.]

First, I am sure you can rely on the safety of the heptatis B virus (HBV) vaccine wherever you are.  Even the products used in developing countries are reliably produced and have never been known to cause any health problem.  Personally, I would not hesitate to be vaccinated against HBV anywhere in the world, as long as I knew that the needle and other injection equipment were sterile and not previously used.

A single dose of HBV vaccine confers very little protection, if any.  Moderate protection results after the second dose, but all 3 doses are required for complete protection.  However, the timing of the subsequent doses isn't all that important.  Dose 2 should be at least 2-3 weeks after the first dose, and dose 3 should be at least 2 months later.  Otherwise, almost any schedule works; you could have dose 2 and 3 any time over the next 1-2 years and probably will then be fully protected.

HBV is acuired only through blood contact or sex.  Indeed, it is much more contagious than HIV, but still not contacted through the sorts of contact you describe.

Bottom line:  Finish your 3-dose HBV vaccine series, wherever you are.  If you aren't reassured by my comments about developing countries and their vaccines, get doses 2 and 3 if/when you return to your own country (which, I am guessing, is China or in SE Asia) or to another industrialized country.  But you should consider yourself entirely unprotected until at least your second dose.

Good luck--  HHH, MD

[matdol]

A related discussion, Hep B Vaccination was started.