Can You Get Multiple Vaccines at Once?

Types Of Hepatitis: A, B, And C

Viral hepatitis is an inflammation of your liver that's caused by a virus. There are five types, but the most common ones in the U.S. Are hepatitis A, B, and C. All of them affect your liver. Some of the symptoms are similar, but they have different treatments.

Hepatitis A. This type won't lead to long-term infection and usually doesn't cause any complications. Your liver heals in about 2 months. You can prevent it with a vaccine.

Hepatitis B. Most people recover from this type in 6 months. Sometimes, though, it causes a long-term infection that could lead to liver damage. Once you've got the disease, you can spread the virus even if you don't feel sick. You won't catch it if you get a vaccine.

Hepatitis C. Many people with this type don't have symptoms. About 80% of those with the disease get a long-term infection. It can sometimes lead to cirrhosis, a scarring of the liver. There's no vaccine to prevent it.

The main way you get hepatitis A is when you eat or drink something that has the hep A virus in it. A lot of times this happens in a restaurant. If an infected worker there doesn't wash their hands well after using the bathroom, and then touches food, they could pass the disease to you.

Food or drinks you buy at the supermarket can sometimes cause the disease, too. The ones most likely to get contaminated are:

You could catch or spread it if you're taking care of a baby and you don't wash your hands after changing their diaper. This can happen, for example, at a day care center.

Another way you can get hep A is when you have sex with someone who has it.

The virus that causes hepatitis B lives in blood, semen, and other fluids in your body. You usually get it by having sex with someone who's infected.

You also can get it if you:

Share dirty needles when using illegal drugs

Have direct contact with infected blood or the body fluids of someone who's got the disease, for instance by using the same razor or toothbrush as someone who has hepatitis B, or touching the open sores of somebody who's infected.

If you're pregnant and you've got hepatitis B, you could give the disease to your unborn child. If you deliver a baby who's got it, they need to get treatment in the first 12 hours after birth.   

Just like hepatitis B, you can get this type by sharing needles or having contact with infected blood. You can also catch it by having sex with somebody who's infected, but that's less common.

If you had a blood transfusion before new screening rules were put in place in 1992, you are at risk for hepatitis C. If not, the blood used in transfusions today is safe. It gets checked beforehand to make sure it's free of the virus that causes hepatitis B and C.

It's rare, but if you're pregnant and have the disease, it's possible to pass it to your newborn.

There are some myths out there about how you get hepatitis C, so let's set the record straight. It's not spread by food and water (like hep A). And you can't spread it by doing any of these things:

The best-known symptom is jaundice, which can make your skin or the whites of your eyes turn yellow.

But not everyone who has hepatitis gets jaundice. You might just feel like you have the flu -- weak, tired, and sick to your stomach. These symptoms are common for many types of hepatitis:

Fever

Loss of appetite

Nausea and vomiting

Stomach pain

Diarrhea

Dark-colored urine

Light-colored bowel movements

Joint pain

See your doctor as soon as possible if you have any of these symptoms.

Sometimes, people have no symptoms. To be sure you have hepatitis, you'll need to get tested.

Many people have mild symptoms or no symptoms, which is why hepatitis is sometimes called a "silent" disease.

Hepatitis A. The symptoms usually show up 2 to 6 weeks after the virus enters your body. They usually last for less than 2 months, though sometimes you can be sick for as long as 6 months.

Some warning signs that you may have hepatitis A are:

Hepatitis B. The symptoms are the same as hepatitis A, and you usually get them 3 months after you're infected. They could show up, though, anywhere from 6 weeks to 6 months later.

Sometimes the symptoms are mild and last just a few weeks. For some people, the hep B virus stays in the body and leads to long-term liver problems.

Hepatitis C. The early symptoms are the same as hepatitis A and B, and they usually happen 6 to 7 weeks after the virus gets in your body. But you could notice them anywhere from 2 weeks to 6 months later.

For about 25% of people who get hep C, the virus goes away on its own without treatment. In other cases, it sticks around for years. When that happens, your liver might get damaged.

Remember, it's possible to spread all the types of hepatitis even if you don't show any signs of being sick.

If your doctor thinks you have hepatitis, there are blood tests to tell if you have type A, B, C, or another type called D. You should get lab results back within a few days.

Some types of hepatitis get better on their own. Others turn into chronic cases and can damage the liver and cause liver cancer. If your doctor thinks you could have chronic hepatitis B or C, they may perform a liver biopsy. That means they'll remove a very tiny piece of your liver with a needle, then send it to a lab to check for liver damage.

The sooner you're tested for a chronic form of hepatitis, the sooner you can take medicine to reduce or stop the damage the virus can cause to your liver.

Many people with hepatitis C don't have symptoms, so they don't know they're infected. That's why it's so important to see a doctor and get tested. Chronic hepatitis C testing is recommended for anyone who:

Was born from 1945 through 1965

Received blood-clotting factor drugs before 1987

Received blood transfusions or an organ transplant before 1992

Has been on dialysis for many years

Injected illegal drugs, even once

Has HIV

Has a known exposure to hepatitis C (such as a health care worker stuck by a needle with blood that is hepatitis C-positive or received an organ or blood transfusion from a donor who has hepatitis C)

Was born to a mother who had hepatitis C

Can Hepatitis Be Treated?

If you have hepatitis A, your doctor will carefully see how well your liver is working, but there aren't any treatments.

There are several drugs that treat long-term hepatitis B, such as:

If you have long-term hepatitis B, you might be a "carrier," which means you can infect others.

Medications called direct-acting antiviral (DAA) treatments can cure many people with hepatitis C. If you haven't been treated before, your doctor may suggest these drugs for hepatitis C:

There are vaccines that prevent hepatitis A and B. There isn't one for hepatitis C.

The CDC recommends that all children get hepatitis A and B vaccines. Adults should get vaccinated if they travel to a country where there are outbreaks or if they're at high risk for the disease.

The hepatitis A virus can live outside the body for months.

Hepatitis B survives for at least 7 days while still being able to cause an infection.

Hepatitis C can live on household and clinic surfaces for up to 6 weeks at room temperature. In open air, it can survive for at least 4 days.

For hepatitis A, one of the best things you can do is wash your hands a lot. That will keep the virus out of food and drinks.

If you have hepatitis B and C, you need to find ways to keep others from making contact with your blood. Follow these tips:

Cover your cuts or blisters.

Carefully throw away used bandages, tissues, tampons, and sanitary napkins.

Don't share your razor, nail clippers, or toothbrush.

If your blood gets on objects, clean them with household bleach and water.

Don't breastfeed if your nipples are cracked or bleeding.

Don't donate blood, organs, or sperm.

If you inject drugs, don't share needles or other equipment.

Strong Demand For Hepatitis A Vaccine Forces Erie-area Clinic To Close Four Hours Early

Mary and Tim Brosius arrived 90 minutes early at Tuesday's hepatitis A vaccine clinic for Cracker Barrel customers who were exposed to the contagious liver disease. The Harborcreek Township couple wanted to ensure they received a shot to protect them.

It was a smart decision.

So many people went to the clinic at the Perry Hi-Way Hose Co. Social Hall in Summit Township that it closed at 3 p.M., four hours early, because it ran out of vaccine.

"We are surprised at the volume," said Erin Mrenak, director of the Erie County Department of Health, which hosted the clinic. "The clinic was running smoothly and efficiently. We are in the process of procuring more vaccine and will have more details (Wednesday)."

The clinic was only open to adults who had eaten food prepared at the Cracker Barrel, 7810 Interstate Drive, from Feb. 10-21. A food-handling employee was diagnosed with hepatitis A on Feb. 22.

It is the only reported case, as of Tuesday at noon.

Birthday meal leads to vaccine clinic visit for Harborcreek couple

Mary and Tim Brosius enjoyed a birthday meal at the Summit Township restaurant about 10 days ago. They were among the first ones to arrive at Tuesday's clinic.

"We were up here anyway, and maybe they would start the vaccine early," said Tim Brosius, 71.

By the time the county Health Department opened the clinic precisely at noon, the social hall's lobby was filled with about 50 people. They had been given numbers to ensure an orderly process.

Any adult who ate food from Cracker Barrel between Feb. 10-Feb. 21 was eligible for a vaccine, as long as they didn't show any symptoms of hepatitis A. The vaccine doesn't work once symptoms have started.

"Once they come in, we send them to registration," Mrenak said shortly after the clinic started. "If they aren't feeling well, we send them to a triage nurse. Otherwise, we take down their information, including when they ate at Cracker Barrel."

Dr. Tim Ward, a volunteer with the Northwest Pennsylvania Medical Reserve Corps, injects Mary Brosius, 70, of Harborcreek Township, with hepatitis A vaccine during a clinic Feb. 27 at the Perry Hi-Way Hose Co. Social Hall, 8281 Oliver Road, Summit Township.

County Health Department staff were joined at the clinic by Northwest Pennsylvania Medical Reserve Corps volunteers. Dr. Tim Ward, a family physician, vaccinated Mary Brosius.

"I could feel the vaccine going into my arm," said Mary Brosius, 70. "I wanted to make sure I got it because I'm a cancer survivor from 30-some years ago."

Mood upbeat among those waiting for hepatitis A vaccine

Most of the nearly 100 people who arrived during the first 45 minutes of the clinic didn't seem to be upset that they were spending their lunch break waiting for a shot. A few old friends held impromptu reunions, compete with hugs and smiles.

Since they arrived so early, Mary and Tim Brosius were able to chat with some of the other people getting vaccinated. Mary Brosius said their moods were upbeat, considering the circumstances.

"Everybody was talking with everyone else as we waited, just killing time," Mary Brosius said.

Joshua Blystone was among the youngest to get vaccinated. The 19-year-old Erie man works at Cracker Barrel as a dishwasher.

The Summit Township restaurant held a vaccination clinic for its employees on Monday, Mrenak said. Blystone said that he didn't hear about it, so he and his mother went to Tuesday's clinic.

Susan Ellsworth, R.N., a nurse with the Erie County Department of Health, gives a dose of hepatitis A vaccine to Joshua Blystone, 19, of Erie, during a hepatitis A vaccine clinic Feb. 27 at the Perry Hi-Way Hose Co. Social Hall, 8281 Oliver Road, Summit Township.

"I work there, and I eat there quite a bit," Blystone said. "I hope this keeps us safe."

Hepatitis A most transmissible, but almost all recover completely

Hepatitis A is only one of several types of hepatitis, but it is the most transmissible, said Dr. Nabeeha Mody-ud-din, a hepatologist with Allegheny Health Network, Saint Vincent Hospital's parent organization.

"If a person is infected with hepatitis A, the disease can spread through their feces," Mody-ud-din said. "They don't practice good hand washing, and they spread it through person-to-person contact or they contaminate food they prepare or handle."

Symptoms usually develop between two and five weeks after exposure and include:

"In most cases, people recover fully from hepatitis A even without treatment," Mody-ud-din said. "In only about 1% of cases does it lead to liver failure. Those at higher risk include people with chronic liver diseases, like cirrhosis, hepatitis B or hepatitis C. Others at risk include those who are immuno-compromised, like those with HIV."

More: Erie-area Cracker Barrel worker diagnosed with Hepatitis A. What should customers know?

Call doctor, pharmacies if you were exposed and still need vaccine

Mody-ud-din agreed with Erie County health officials that any adult who ate food prepared at Cracker Barrel on those dates should get vaccinated.

Those who weren't vaccinated at Tuesday's clinic should contact their health provider or local pharmacies. The county Health Department has a help line for those with questions: 814-451-6707.

Children are likely protected through the hepatitis A vaccines that are part of their childhood immunization requirements.

"The hepatitis A vaccine usually lasts for 10 to 15 years," Mody-ud-din said.

Contact David Bruce at dbruce@timesnews.Com. Follow him on X @ETNBruce.

This article originally appeared on Erie Times-News: County Health Department's Hepatitis A vaccine clinic closes early

A Man Deliberately Got 217 Covid Shots. Here's What Happened

One German man has redefined "man on a mission." A 62-year-old from Magdeburg deliberately got 217 COVID-19 vaccine shots in the span of 29 months, according to a new study, going against national vaccine recommendations. That's an average of one jab every four days.In the process, he became a walking experiment for what happens to the immune system when it is vaccinated against the same pathogen repeatedly. A correspondence published Monday in the journal Lancet Infectious Diseases outlined his case and concluded that while his "hypervaccination" did not result in any adverse health effects, it also did not significantly improve or worsen his immune response.The man, who is not named in the correspondence in compliance with German privacy rules, reported receiving 217 COVID-19 shots between June 2021 and November 2023. Of those, 134 were confirmed by a prosecutor and through vaccination center documentation; the remaining 83 were self-reported, according to the study."This is a really unusual case of someone receiving that many Covid vaccines, clearly not following any type of guidelines," said Dr. Emily Happy Miller, an assistant professor of medicine and of microbiology and immunology at Albert Einstein College of Medicine who did not participate in the research.The man did not report any vaccine-related side effects and has not had a COVID-19 infection to date, as evidenced by repeated antigen and PCR testing between May 2022 and November 2023. The researchers caution that it's not clear that his Covid status is directly because of his hypervaccination regimen."Perhaps he didn't get Covid because he was well-protected in the first three doses of the vaccine," Miller said. "We also don't know anything about his behaviors."Dr. Kilian Schober, senior author of the new study and a researcher at the Friedrich-Alexander University Erlangen-Nürnberg, said it is important to remember that this is an individual case study, and the results are not generalizable.The researchers also say they do not endorse hypervaccination as a strategy to enhance immunity."The benefit is not much bigger if you get vaccinated three times or 200 times," Schober said.Raising suspicionsAccording to his immunization history, the man got his first COVID vaccine in June 2021. He got 16 shots that year at centers across the eastern state of Saxony.He ramped up his efforts in 2022, rolling up his sleeves for shots in both his right and left arms almost every day in January, for a total of 48 shots that month.Then he kept going: 34 shots in February and six more shots in March. Around this time, German Red Cross staff members in the city of Dresden became suspicious and issued a warning to other vaccination centers, encouraging them to call the police if they saw the man again, CNN affiliate RTL reported in April 2022.In early March, he showed up at a vaccination center in the town of Eilenburg and was detained by police. He was suspected of selling the vaccination cards to third parties, according to RTL. This was during a time when many European countries required proof of vaccination to access public venues and travel.The public prosecutor in Magdeburg opened an investigation into the man for the unauthorized issuing of vaccination cards and forgery of documents but did not end up filing criminal charges, according to the study.Video below: CDC said anyone 65 or older should get another COVID-19 vaccine doseEffects of hypervaccinationThe researchers read about the man in the news and reached out to him through the prosecutor investigating his case in May 2022. By this point, he was 213 shots in.He agreed to provide medical information, blood and saliva samples. He also proceeded to get four more COVID shots, against the researchers' medical advice, Schober said.The researchers analyzed his blood chemistries, which showed no abnormalities linked to his hypervaccination. They also looked at various markers to evaluate how his adaptive immune system was functioning, according to the study.The adaptive immune system is the subsection of the immune system that learns to recognize and respond to specific pathogens when you encounter them throughout your life, Miller said. There are two main cell types in the adaptive immune system, T cells and B cells.In chronic diseases, such as HIV and hepatitis B, immune cells can become fatigued from frequent exposure to the pathogen and lose the ability to combat it effectively, Schober said. Hypervaccination, in theory, could have a similar effect.However, that's not what the researchers found. Hypervaccination in this case increased the quantity (the number of T cells and B cell products) but did not affect the quality of the adaptive immune system, according to the study. "If you take the allegory of the immune system as an army, the number of soldiers is higher, but the soldiers themselves are not different," Schober said.In total, the man got eight vaccine formulations, including mRNA vaccines from Pfizer/BioNTech and Moderna, a vector-based vaccine from Johnson & Johnson and a recombinant-protein vaccine from Sanofi."The observation that no noticeable side effects were triggered in spite of this extraordinary hypervaccination indicates that the drugs have a good degree of tolerability," Schober said in a news release.While very interesting from a scientific perspective, individual case studies like this must always be taken with a grain of salt, Miller said. Public health recommendations, which are based on very large, randomized control trials, are what people should look to for guidance, she added."I don't think any physician or public health official would recommend doing what this gentleman did. This is really uncharted territory," Miller said. "Talk to your doctor, follow the recommended vaccine schedules, and that should be the best thing to keep you both protected from Covid and healthy and safe."The U.S. Centers for Disease Control and Prevention recommends COVID-19 vaccination for everyone ages 6 months or older in the United States, following the vaccination schedules outlined on its website. Last week, the CDC updated its guidance to recommend an additional dose of the current COVID-19 vaccine for people 65 and older.Less than a quarter of adults and only 13% of children in the U.S. Have gotten the most recently recommended COVID-19 vaccine, according to CDC data.

One German man has redefined "man on a mission." A 62-year-old from Magdeburg deliberately got 217 COVID-19 vaccine shots in the span of 29 months, according to a new study, going against national vaccine recommendations. That's an average of one jab every four days.

In the process, he became a walking experiment for what happens to the immune system when it is vaccinated against the same pathogen repeatedly. A correspondence published Monday in the journal Lancet Infectious Diseases outlined his case and concluded that while his "hypervaccination" did not result in any adverse health effects, it also did not significantly improve or worsen his immune response.

The man, who is not named in the correspondence in compliance with German privacy rules, reported receiving 217 COVID-19 shots between June 2021 and November 2023. Of those, 134 were confirmed by a prosecutor and through vaccination center documentation; the remaining 83 were self-reported, according to the study.

"This is a really unusual case of someone receiving that many Covid vaccines, clearly not following any type of guidelines," said Dr. Emily Happy Miller, an assistant professor of medicine and of microbiology and immunology at Albert Einstein College of Medicine who did not participate in the research.

The man did not report any vaccine-related side effects and has not had a COVID-19 infection to date, as evidenced by repeated antigen and PCR testing between May 2022 and November 2023. The researchers caution that it's not clear that his Covid status is directly because of his hypervaccination regimen.

"Perhaps he didn't get Covid because he was well-protected in the first three doses of the vaccine," Miller said. "We also don't know anything about his behaviors."

Dr. Kilian Schober, senior author of the new study and a researcher at the Friedrich-Alexander University Erlangen-Nürnberg, said it is important to remember that this is an individual case study, and the results are not generalizable.

The researchers also say they do not endorse hypervaccination as a strategy to enhance immunity.

"The benefit is not much bigger if you get vaccinated three times or 200 times," Schober said.

Raising suspicions

According to his immunization history, the man got his first COVID vaccine in June 2021. He got 16 shots that year at centers across the eastern state of Saxony.

He ramped up his efforts in 2022, rolling up his sleeves for shots in both his right and left arms almost every day in January, for a total of 48 shots that month.

Then he kept going: 34 shots in February and six more shots in March. Around this time, German Red Cross staff members in the city of Dresden became suspicious and issued a warning to other vaccination centers, encouraging them to call the police if they saw the man again, CNN affiliate RTL reported in April 2022.

In early March, he showed up at a vaccination center in the town of Eilenburg and was detained by police. He was suspected of selling the vaccination cards to third parties, according to RTL. This was during a time when many European countries required proof of vaccination to access public venues and travel.

The public prosecutor in Magdeburg opened an investigation into the man for the unauthorized issuing of vaccination cards and forgery of documents but did not end up filing criminal charges, according to the study.

Video below: CDC said anyone 65 or older should get another COVID-19 vaccine dose

Effects of hypervaccination

The researchers read about the man in the news and reached out to him through the prosecutor investigating his case in May 2022. By this point, he was 213 shots in.

He agreed to provide medical information, blood and saliva samples. He also proceeded to get four more COVID shots, against the researchers' medical advice, Schober said.

The researchers analyzed his blood chemistries, which showed no abnormalities linked to his hypervaccination. They also looked at various markers to evaluate how his adaptive immune system was functioning, according to the study.

The adaptive immune system is the subsection of the immune system that learns to recognize and respond to specific pathogens when you encounter them throughout your life, Miller said. There are two main cell types in the adaptive immune system, T cells and B cells.

In chronic diseases, such as HIV and hepatitis B, immune cells can become fatigued from frequent exposure to the pathogen and lose the ability to combat it effectively, Schober said. Hypervaccination, in theory, could have a similar effect.

However, that's not what the researchers found. Hypervaccination in this case increased the quantity (the number of T cells and B cell products) but did not affect the quality of the adaptive immune system, according to the study.

"If you take the allegory of the immune system as an army, the number of soldiers is higher, but the soldiers themselves are not different," Schober said.

In total, the man got eight vaccine formulations, including mRNA vaccines from Pfizer/BioNTech and Moderna, a vector-based vaccine from Johnson & Johnson and a recombinant-protein vaccine from Sanofi.

"The observation that no noticeable side effects were triggered in spite of this extraordinary hypervaccination indicates that the drugs have a good degree of tolerability," Schober said in a news release.

While very interesting from a scientific perspective, individual case studies like this must always be taken with a grain of salt, Miller said. Public health recommendations, which are based on very large, randomized control trials, are what people should look to for guidance, she added.

"I don't think any physician or public health official would recommend doing what this gentleman did. This is really uncharted territory," Miller said. "Talk to your doctor, follow the recommended vaccine schedules, and that should be the best thing to keep you both protected from Covid and healthy and safe."

The U.S. Centers for Disease Control and Prevention recommends COVID-19 vaccination for everyone ages 6 months or older in the United States, following the vaccination schedules outlined on its website. Last week, the CDC updated its guidance to recommend an additional dose of the current COVID-19 vaccine for people 65 and older.

Less than a quarter of adults and only 13% of children in the U.S. Have gotten the most recently recommended COVID-19 vaccine, according to CDC data.

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