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OMG I can not understand why we are having this Safety Lesson on Hepatitis A and B Shots!

Even with all the data on the market and industry on Hep B and now Hep A shots why are people not getting shots to prevent these workplace incidents. * And although there is no specific vaccine for hepatitis D, being immunized against hepatitis B will prevent you from contracting hepatitis D.The good news is that hepatitis A can be prevented by vaccination. A variety of vaccines are available to make immunization fit your needs. The vaccine will prevent you from contracting hepatitis A and from being a potential source of infection to others.

Hepatitis C    At this time, there is no vaccine for hepatitis C. However, all people with chronic liver disease, including hepatitis C, should be immunized against both hepatitis A and B. A second infection by either virus can compound the damage to your liver. For those whose hepatitis C is more advanced, drug treatment may be appropriate and must be administered after careful assessment by your physician.

What is hepatitis A?

Hepatitis A is a viral disease that is common in developing countries and is generally associated with poor sanitation and poor hygiene. It is one of the most common vaccine-preventable illnesses in travellers.

In Canada, immunization is recommended for individuals at increased risk of infection. For example, you are at increased risk if you:

  • plan to travel internationally
  • have not received the complete series of immunizations against hepatitis A
  • are unsure if you have received the full series of immunizations
  • are a man who has sex with men
  • use street drugs
  • have chronic liver disease.

What is my risk?    

Your risk depends on several factors: destination, length of trip, and your living conditions.

The risk of hepatitis A is highest among travellers:

  • visiting or living in rural areas
  • eating and drinking in locations with poor sanitation or unsafe food handling practices

The risk of hepatitis A exists even for travellers going for short periods of time to urban areas, staying in luxury hotels and who follow good hygiene and water and food precautions.

How is it transmitted?         

  • The hepatitis A virus is found in the stool (feces) of an infected person.
  • It can be spread through contaminated food and water or through close contact with an infected person.
  • Certain uncooked foods such as shellfish, fruits or salads can be contaminated, as well as foods that are prepared in unsanitary conditions or by an infected person with unsafe food handling practices.
  • It can also be transmitted through close personal contact when poor hygiene is practised:
    • in day cares, households, schools, etc.
    • less commonly, through sexual contact.
  • Infection with the virus gives lifelong immunity (protection) against the virus.

What are the symptoms?

  • Symptoms can take from 15 to 50 days to appear (average 28 days).
  • Some people who are infected have no symptoms, others may have only mild symptoms that last from 1 to 2 weeks and some may experience more severe symptoms that can last several months.
  • In children, symptoms are mild to non-existent. Severity of the illness increases with age.
  • Symptoms can include fever, fatigue, loss of appetite, nausea and vomiting, abdominal discomfort, dark urine and grey-colored stool, jaundice (yellowing of skin and whites of eyes).
  • In severe and rare occasions, symptoms can include liver damage, liver failure, or death. Individuals with pre-existing chronic liver disease and older people are most at risk for this.
  • Recovery generally takes a few weeks, but can take months. Most people recover without side effects and have lifelong immunity against hepatitis A.


  • Hepatitis A (HA) infection usually causes clinical hepatitis in adults and older children; it often causes a febrile illness without jaundice or is asymptomatic in younger children.
  • Pre-exposure HA immunization is at least 90% to 97% effective.
  • Reactions to HA vaccine are generally mild and transient and include soreness and redness at the injection site.


  • Pre-exposure HA immunization is recommended for people at increased risk of infection or severe HA including:
    • Travellers to HA-endemic countries
    • Individuals with chronic liver disease
    • Men who have sex with men (MSM)
    • Injectable and non-injectable illicit drug users
    • Individuals living in communities at risk of HA outbreaks or in which HA is endemic
    • Household or close contacts of children adopted from HA-endemic countries
    • Military personnel and humanitarian relief workers
    • People receiving repeated replacement of plasma-derived clotting factors
    • Workers involved in research on HA virus or production of HA vaccine who may be exposed to HA virus
    • Zoo-keepers, veterinarians and researchers who handle non-human primates
  • Post-exposure prophylaxis should be offered to susceptible:
    • household and close contacts of people infected with HA
    • contacts in group child care centres and kindergartens
    • co-workers and clients of infected food handlers


  • Primary immunization is achieved with 1 dose of monovalent HA vaccine with a booster dose given 6 to 36 months later, depending on the product.
  • With few exceptions, people with indications for both HA and hepatitis B (HB) vaccine should be immunized with combined HAHB vaccine..
  • HA vaccines may be administered concomitantly with other vaccines.

In the United States alone, Each year about 2,000 people in the United States die from hepatitis B-related liver disease.

Hepatitis B (HB) virus is a deoxyribonucleic acid (DNA) virus of the Hepadnavirdiae family. The following two antigens are important in evaluating people with HB infection and are markers of HB carriage: hepatitis B surface antigen (HBsAg), which is present in either acute or chronic infection with HB virus and hepatitis B e antigen (HBeAg), which typically is associated with higher viral loads, increased infectiousness and more actively replicating virus. Increasingly, viral loads are followed as indicators of infectiousness and response to treatment.

  • In Canada, most acute cases of hepatitis B (HB) occur in unimmunized people 25 years of age and older who acquire infection through unprotected sexual activity, sharing injection drug equipment, household contact with a HB carrier or procedures with percutaneous exposure. A high proportion of HB carriers in Canada are immigrants from HB endemic areas.
  • Initial infection with HB may be asymptomatic in up to 50% of adults and 90% of children.
  • Infants, young children and immunocompromised persons are at highest risk of becoming chronic HB carriers.
  • HB vaccine is 95% to 100% effective pre-exposure.
  • Reactions to HB vaccine are generally mild and transient and include: irritability, headache, fatigue, as well as pain and redness at the injection site.


  • Routine HB immunization is recommended for all children.
  • Pre-exposure HB immunization is recommended for high risk groups.
  • Post-exposure prophylaxis should be offered to:
    • infants born to HB-infected mothers
    • persons potentially exposed to blood or bodily fluids containing HB virus
    • household and sexual contacts of an acute HB case or chronic carrier


  • There are many different HB-containing vaccine schedules and dosages.
  • For monovalent HB vaccine, the preferred schedule (particularly for infants) is months 0, 1 and 6. The date of the first dose for infants is at birth, which is considered as month 0.
  • With few exceptions, persons with indications for both hepatitis A (HA) and HB vaccine should be immunised with combined HAHB vaccine.
  • Hepatitis B-containing vaccines may be administered concomitantly with other vaccines at different injection sites using separate needles and syringes.


  • A person with acute HB can become a chronic carrier and remain infectious. Chronic infection may lead to serious liver disease.

Infants born to infected mothers are at highest risk of becoming chronic HB carriers.

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