Hepatitis B vaccination guide

As long as you have not been infected with hepatitis B virus and the hepatitis B surface antibody titer in your body is less than 10mIU/ml (or the antibody is negative), vaccination is recommended regardless of age group； High-risk groups such as medical staff and family members who have hepatitis B infection, are often exposed to blood products, and have multiple sexual partners should be given priority for vaccination and regular monitoring of antibody levels.

Last week, I was helping an elderly family member get antihypertensive medicine at a community hospital. I happened to meet an old acquaintance from the vaccination department, Sister Zhang. She received a dozen people in the morning who came to ask about the hepatitis B vaccine: the kindergarten teacher who had just joined the job was afraid of being infected by contact with children. The pregnant mother who had just found out that her husband was a hepatitis B carrier came in a panic and asked if she wanted to get vaccinated again. There was also a retired teacher who said that he had been vaccinated thirty years ago and whether he still needs to be vaccinated again. In fact, most people only have a few questions that go around. Combining my previous experience in rotating in the Department of Infectious Diseases and the current consensus in the academic community, I will clarify it for everyone.

First, let’s talk about the most frequently asked question: Do I need to get tested before vaccination? There are indeed two different practical ideas in clinical practice. One is that if you find it troublesome, you can get vaccinated directly. Even if you have accidentally been infected with hepatitis B, vaccination will not cause additional harm to the body, but it will not have a protective effect, so there will be no harm. The other option is to spend tens of dollars to get tested for five hepatitis B tests (also known as two and a half). If you already have enough antibodies or are infected with hepatitis B, you don’t have to spend money on injections, which is more cost-effective. I tend to check first. Last year, I checked for antibodies for my cousin who just graduated. Her titer was still 87mIU/ml. I saved the money of three injections and didn’t have to suffer. Why not do it.

Let’s talk about the most controversial issue of “should lifelong re-injection be necessary?” This academic circle has not yet come to a unified conclusion. One school of thought is that as long as you have clearly produced antibodies after vaccination, even if the titer drops below 10 later, the body's immune memory will still be there. Once exposed to hepatitis B virus, the immune response will be quickly awakened and it will almost never develop into a chronic infection, so there is no need to monitor and re-inject regularly. The other school of thought is more pragmatic: high-risk groups still need to be tested every 3-5 years, and if the antibody titer is not enough, they should get a booster shot. After all, the probability of these people being exposed to the virus is much higher than that of ordinary people, so there is no harm in taking stricter precautions. I met a nurse at a dialysis center before who checked for antibodies every year. The titer dropped to 7 the year before last, so she immediately received a booster shot. After a month, the titer rose to more than 300. She said that she comes into contact with so many patients with complex underlying diseases every day, and it is better to have an extra layer of protection than to be afraid.

Of course, some situations are uncontroversial, such as the vaccination of newborns. The country now provides free vaccination to all newborns. The first injection is given within 24 hours after birth, and the second and third injections are given at 1 month and 6 months old respectively. If the mother is hepatitis B surface antigen positive, in addition to the regular vaccine, the baby must also receive hepatitis B immune globulin within 12 hours. The blocking rate can reach more than 95%. This policy has really reduced the hepatitis B infection rate among children in my country by several orders of magnitude. There are also people with low immune function, such as those who have undergone organ transplantation and are taking immunosuppressants, or AIDS patients. Regular doses of the vaccine may not produce enough antibodies. You can consult a doctor for a double dose, or the newly released recombinant high-end vaccine, the antibody conversion rate will be much higher.

Oh, by the way, don’t think that you’re in the safe after getting vaccinated. I once met a young man who went to an unqualified shop to get a tattoo without checking his antibodies after getting vaccinated. He happened to encounter tools that were not properly sterilized and was still infected with acute hepatitis B. If you still can’t detect antibodies after three injections of the regular vaccine, you can get another round of booster injections. If you still have no reaction, you don’t need to take it again and again. Just pay more attention to it: don’t go to unqualified places to get your teeth cleaned, get tattoos, or have your ears pierced. Don’t share personal items like toothbrushes and razors that may be stained with blood with others. The probability of infection is actually very low.

Many people are afraid of the side effects of the vaccine. To be honest, most people I have seen have arm soreness for a day or two after the vaccine. A very few people will have a slight fever, which will go away in a day or two. The side effects are much smaller than those of a common cold. There is really no need to be too anxious.

In fact, to put it bluntly, there is really not much to worry about about the hepatitis B vaccine. If you belong to a high-risk group or are around someone who is infected, it doesn’t cost much to check for antibodies, so you should get it. If you are not sure about your situation, go to the community vaccination site near your home and ask. It is much more reliable than searching for all kinds of alarmist posts on the Internet for a long time. Of course, if you have already been infected with hepatitis B, there is no use in getting vaccinated. Just go to the infectious disease department for regular check-ups and follow the doctor's advice to control your condition. There is no need to panic.