However, 15%–40% of people with chronic HBV infection will develop liver cirrhosis, hepatocellular carcinoma, or liver failure, and 25% die prematurely of these complications. The vaccine works by exposing you to a small dose of the virus, which causes the body to develop immunity to the disease. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Whenever feasible, the same manufacturer’s vaccines should be used to complete the series; however, vaccination should not be deferred when the manufacturer of previously administered doses is unknown or when the vaccine from the same manufacturer is unavailable. There are no data on use of 2-dose series vaccines (Heplisav-B) in pregnant women.

The third dose of Engerix-B should not be administered before age 24 weeks. Ann Intern Med. Hajj visas cannot be issued without proof that applicants received meningococcal vaccine ≥10 days and ≤3 years (≤5 years for conjugate vaccine) before arriving in Saudi Arabia. Japanese encephalitis vaccine is administered as 2 doses on days 0 and 7–28 (see Chapter 4, Japanese Encephalitis). Travelers for whom the yellow fever vaccination is contraindicated can be issued a medical waiver letter if a country entry requirement (and not risk of yellow fever infection) is the only reason to vaccinate.

Alternatively, the clinician can help them identify resources for vaccination with Ixiaro or several alternative vaccines that may be available at their destination, particularly if they will be long-stay travelers (Imojev Sanofi, SA14-14-2 Chengdu). Consider building flexibility into the clinic schedule and proactively identifying people likely to travel at the last minute (such as college students and corporate employees).

Follow your doctor's instructions about any restrictions on food, beverages, or activity. Typically, the incubation period for hepatitis B is 90 days (range, 60–150 days). Otherwise, the traveler risks being denied entry at the country’s border and would be at risk for yellow fever.

The accelerated vaccination schedule for the combined hepatitis A and hepatitis B vaccine, Twinrix, calls for vaccine doses administered at days 0, 7, and 21–30; a booster dose should be administered at 12 months to promote long-term immunity. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. There is no need to start over.

Hepatitis B vaccination, screening, and linkage to care: best practice advice from the American College of Physicians and the Centers for Disease Control and Prevention. Postexposure prophylaxis with hepatitis B immune globulin (HBIG) administered in conjunction with hepatitis B vaccine is effective in preventing transmission after exposure to HBV; hepatitis B vaccine alone may also be used if HBIG is not available. Wong C and Scotland L. The last minute traveller. For more information about this message, please visit this page: Centers for Disease Control and Prevention. Washington D.C. Public Health Foundation; [cited 2018 Apr]. For this reason, some items on this page will be unavailable. Epidemiology and Prevention of Vaccine-Preventable Diseases. redness, tenderness, or a hard lump where the shot was given; This is not a complete list of side effects and others may occur. Refer the traveler to use­ful websites such as CDC (www.cdc.gov/travel), the Department of State (www.travel.state.gov), the Heading Home Healthy Program (www.headinghomehealthy.org), and the International Society of Travel Medicine clinic directory (www.istm.org). It is very affordable. A person who starts but does not complete a primary series and is exposed should receive the same postexposure prophylaxis as a completely unimmunized person. An approved accelerated vaccination schedule can be used for people traveling on short notice who face imminent exposure or for emergency responders to disaster areas. Hepatitis a adult vaccine/hepatitis b adult vaccine drug interactions (in more detail). All travelers should be aware of how HBV is transmitted and take measures to minimize their exposures. Getting poked with a needle is never fun, but it’s an extremely important part of protecting yourself and others from infectious diseases! 2015 Jul 28;386(10003):1546–55. Your doctor may want you to remain under observation during the first 15 minutes after the injection. Auckland (NZ): Adis; 2015. pp. U.S. Department of Health & Human Services.