Hepatitis B vaccination guide

Regardless of age, as long as the hepatitis B surface antibody (anti-HBs) test result is negative or the antibody titer is less than 10mIU/ml, it is recommended to receive hepatitis B vaccine； The 0-1-6 schedule is sufficient for routine vaccination (the second and third doses are given 1 month and 6 months apart after the first dose). It is recommended for high-risk groups to recheck the antibody titer every 1-2 years and give a booster shot if it is below the threshold.

Last year, I worked in the community public health department for more than three months. I dealt with various types of vaccines every day and encountered too many questions about the hepatitis B vaccine. Some people thought that if they were vaccinated as children, they would be protected for life. Some people were so scared when they found out that the antibody titer was 8. I searched "can hepatitis B be transmitted through eating" all night long. Some people heard that the vaccine has side effects and were afraid to take it. I simply clarified the common questions and practical experience, so that everyone no longer has to guess.

It's interesting to say that there are actually different views in the industry on "whether routine screening and re-vaccination of hepatitis B vaccine should be done in adulthood": one group is the mainstream opinion of the disease control system, which believes that healthy adults who have been vaccinated with 3 doses of hepatitis B vaccine in the newborn period can maintain at least 15-20 years of protection. Even if the subsequent antibody titer drops to undetectable, the immune memory in the body is still there, and the immune response can be quickly activated once exposed to the hepatitis B virus. The effect of preventing severe disease is still sufficient, and there is no need to go out for annual screening and re-vaccination.； The other side is the advice of clinical infectious diseases doctors. They believe that if you are medical staff, kindergarten teachers, practitioners who often come into contact with blood products, or high-risk groups with hepatitis B virus carriers in your family or multiple sexual partners, you still need to check for antibodies once a year and take supplements when necessary. After all, the risk of exposure is much higher than that of ordinary people. Both statements are supported by data. You can choose based on your own life scenarios, and you don’t have to stick to a certain standard.

Many people ask if they need to fast before getting the injection. It’s really not necessary. You can just have soy milk and fried dough sticks before taking the injection. As long as you don’t get drunk the day before, have a fever, rash, or an acute illness. Last month, I met a young man who had a fever of 38.5 degrees and insisted on getting vaccinated. He said he had to go on a business trip next week and had no time. After persuading him for a long time, he agreed to wait until the fever subsided. This is not to say that serious problems would occur if he had a fever, but he was vaccinated when he was not feeling well. If he had fatigue or headache, he would not be able to tell whether it was a problem with the vaccine or the cold itself, which would only add to his anxiety.

As for the side effects that everyone is most worried about, I have met thousands of people who received the hepatitis B vaccine in the past three months. More than 90% of them suffered from soreness at the injection site for a day or two, and at most a low fever of about 37.5 degrees. It subsided after drinking two glasses of water and sleeping. The only aunt I met complained that "she couldn't lift her arm after the injection." Later, when I asked her carefully, I found out that she went to square dance the same day after the injection and danced the flower rope for 20 minutes. Would that not hurt? It really has nothing to do with vaccines.

There is also a special group of people. After taking three injections according to 0-1-6, the antibodies still have not risen. The industry calls them "vaccine non-responsive people". There are also different opinions on the treatment of this type of people: some studies believe that there is no need to fight again, even if there are no detectable antibodies, immune memory has been formed at the cellular level, and true exposure to the virus will not develop into chronic hepatitis B. ； Some doctors also suggest that if you are a high-risk group, you can change the vaccine to a different process (for example, the yeast recombinant vaccine you used before can be replaced by CHO cell vaccine), and then take another round of high-dose vaccine. About half of the people can induce enough antibodies. In fact, ordinary people don’t have to worry about this at all. Hepatitis B is not spread through daily meals, handshakes, and hugs. Even if you don’t have antibodies, there is almost no risk of exposure in normal life. If you don’t worry, there is no harm in taking one more round.

I will be tested for hepatitis B two and a half every year during my physical examination. After all, my mother is a hepatitis B virus carrier. We usually eat and live together, so it is better to pay more attention. The last time I checked for antibodies, I still had 87mIU/ml. I estimate that I will need a booster shot in four to five years. If you are not sure about your situation, don’t search for those scary marketing articles on the Internet. Go downstairs to a community hospital to get a blood draw. It costs more than 20 yuan and the results will be available in half an hour. You can ask the doctor from the public health department to ask a few questions. It is more reliable than anything else.