Author:
Tim (eder)
[ Edit | View ]
|
Date Posted: Tuesday, January 07, 2020, 01:51: am
Do you mean this letter although not formatted. For a formatted version email me
Hepatitis A/B & Adolescent Vaccination Notice
______________________________________________
September 1, 2020
Draft 49018.16
Recommendations of the Advisory Committee on Immunization Practices (ACIP), the
American Academy of Pediatrics (AAP), the American Academy of Family Physicians
(AAFP) and the American Medical Association (AMA)
The following CDC staff members prepared this report:
Francisco M. Averhoff, M.D., M.P.H.
Walter W. Williams, M.D., M.P.H.
Stephen C. Hadler, M.D.
Epidemiology and Surveillance Division
National Immunization Program
Notice Regarding Mandatory Hepatitis A/B Vaccination
For Upcoming School Year
Recommendations of the Advisory Committee on Immunization Practices (ACIP), the
American Academy of Pediatrics (AAP), the American Academy of Family Physicians*
(AAFP) and the American Medical Association* (AMA)
This statement on adolescent immunization is a supplement to the "General Recommendations on Immunizations" of the Advisory Committee on Immunization Practices (ACIP). This statement presents a new strategy to improve the delivery
of vaccination services to adolescents and integrate recommendations for immunization with other preventive services provided to adolescents.
Dear Jacquelyn and Elena xxxxxxxxxxx,
This letter is being sent to you to provide important information regarding the new State Mandated Hepatitis A/B Vaccination Requirement. Both of you will have to receive mandatory Hepatitis A/B vaccinations within 10 days or you will not be allowed to attend class. This letter will:
(1) Provide information about the Hepatitis A/B infection.
(2) Provide information regarding the administration of the Hepatitis vaccine.
(3) Help you cope with the pain of the Hepatitis A/B injection.
In the United States, most persons acquire Hepatitis A/B virus (HBV) infection as adolescents or young adults. HBV is primarily transmitted through sexual contact, use of injection drugs, and household contact with a chronically infected person, or occupational exposure. However, over one-third of persons with acute Hepatitis A/B do not have a readily identifiable source for their infection (8).
An immunization visit at age 11-15 years, before adolescents begin high-risk behaviors, is an ideal time to initiate the Hepatitis A/B immunization. In addition, older unvaccinated adolescents with identified risk factors for HBV infection should also be vaccinated (9). To achieve complete immunization, providers may offer Hepatitis A/B vaccine to all adolescents in their practice as recommended by the AAP (12). The Hepatitis A/B immunization is different from any other Hepatitis immunization you may have already received.
You will receive three doses of Hepatitis A/B vaccine given in schedules of: 0, 1, and 9 months; or in certain cases 0, 0, and 6 months. If the vaccination schedule is interrupted, it is not necessary to restart the vaccine series. Although studies have not examined all possible variations, studies of "off schedule" vaccination indicate the following approach if the series is interrupted after the first dose: 1) another dose should be given as soon as possible and the third dose should be separated by an interval of at least 6 months, and 2) if only the third dose is delayed, it should be administered as soon as possible. Intervals of up to nine months between the first and third doses have been found to result in excellent antibody responses and studies are in progress to evaluate longer intervals (16).
The entire series will take 9 months to complete. If given in less than 9 months, *2 doses will be required at the first visit, these being considered doses 0 and 1. It will then be necessary for the physician to administer two separate injections during the initial visit. The third dose must be administered no later than 6 months from the first two.
*Since the State mandate requires that all students be fully immunized by January 1, 2003, there is no longer a nine month period to complete the full series. Therefore, it will be necessary for you to use the alternate vaccination schedule of 0, 0 and 6 months. This will mean that you will be receiving the first two doses at the initial visit and the third dose six months later.
Administration of the Hepatitis A/B vaccination is intramuscular and is administered in the buttocks. In the case of multiple injections at first visit, the nurse or doctor will alternate sides of the buttocks for each injection. A nurse or parent should be present to assist in holding you steady to prevent any movement during the injection.
Because the Hepatitis A/B vaccine is recombinant (a mixture), the dosage is large and the serum is thick. The serum is also caustic (it burns), as there is some degree of tissue damage when coming in contact with muscle tissue. The duration of the injection usually takes between 2 and 3 minutes. It is important that you remain still during this period. The serum must reach the inner most part of the muscle and must be administered in the buttocks. It cannot be given in the upper arm or thigh. Up until 2001, it had been administered in the upper arm. However, this was found to lose effectiveness. Further studies have shown this to be true.
The Hepatitis A/B injection is painful. You should lie on your stomach in a relaxed position with your toes pointing inward toward each other. This will allow the physician or nurse to directly administer the injection safely. It is recommended that a nurse or parent hold you steady to prevent any movement due to pain.
When the injection is administered, you will feel a sharp stick from the insertion of the needle. You will then feel the needle go deeper into the muscle. This does hurt. You may want to hold your mothers, or the nurses hand, to ease some of the pain. It is important to hold still during this period even though it is painful. After the needle is fully inserted, you will feel a very intense burning sensation. This will last and perhaps increase, for the duration of the injection, between 2 and 3 minutes. Remain still during this period.
The needle must be between 21/4 and 2 inches long and between 18 and 21 gauge in diameter to reach the necessary part of the inner muscle. Therefore, the physician or nurse will insert it with a strong jabbing motion. It is okay to scream or cry if that will help you stay still. When the needle is removed, there will be another sharp pain. At this point, the physician or nurse will quickly swab the area with alcohol to prevent infection. Due to the long duration of the injection and the thickness of the serum, the site of injection will remain sore. This will last anywhere between 1 to 2 weeks. If the pain does not subside after this period, contact your physician.
As mentioned earlier, it is okay to scream or cry if that allows you to remain still. Do not feel embarrassed for this is common among anyone receiving these injections.
The consideration of the mandatory Hepatitis A/B vaccination, while painful, has been made in order to protect you from a very debilitating disease. Although it is a painful experience when receiving the Hepatitis A/B injections, the long-term benefits will help you.
The above recommendations for each vaccine are consistent with the current ACIP.
Hepatitis A/B Virus Infection: Adolescent Information
American Academy of Pediatrics
[ Post a Reply to This Message ]
|
Feedback: 
