Hepatitis B vaccine is not lifelong immunization. Please keep this vaccination guide.
Original Jiulu Medical Digestive Liver Disease Channel was included in the collection # World Hepatitis Day 4 # Hepatitis B 3 # Hepatitis B Vaccine 1.
For medical professionals’ reference only.
Actively vaccinate against hepatitis B and eliminate hepatitis B at an early date.
China is a country with high prevalence of hepatitis B infection. It is estimated that there are about 70 million people infected with chronic hepatitis B virus (HBV), including 20-30 million patients with chronic hepatitis B.
Since hepatitis B was included in the planned immunization management in China in 2002, the survey in 2014 showed that the number of hepatitis B carriers among children under 5 years old dropped to 0.32%, which means that more than 80 million children have been protected from hepatitis B infection since the implementation of hepatitis B vaccine. So who needs hepatitis B vaccine? How long does the protection last? Do you want to replant?
On July 28th, World Hepatitis Day, the "medical community" invited Professor Jiang Yongfang, member of the Infectious Diseases Branch of the Chinese Medical Association and director of the Infectious Diseases Department of the Second Xiangya Hospital of Central South University, to make a detailed interpretation of hepatitis B vaccination according to the Guidelines for the Prevention and Treatment of Chronic Hepatitis B (2019) (hereinafter referred to as the "Guidelines").
Hepatitis B vaccine is the most effective way to prevent HBV infection.
"Hepatitis B vaccine mainly reduces or avoids hepatitis B infection by producing effective hepatitis B surface antibodies after inoculation. However, with the extension of time, the protection of hepatitis B surface antibodies will also decrease. " Director Jiang introduced.
Different people are vaccinated with hepatitis B vaccine, and the precautions are different. For high-risk groups, such as medical personnel, people engaged in food processing, and people whose immediate family members are infected with hepatitis B, they should be vaccinated with hepatitis B vaccine and tested for hepatitis B surface antibodies for 3-5 years. Director Jiang said: "For patients whose titer of hepatitis B surface antibody is less than 100, they should be strengthened or re-vaccinated with hepatitis B vaccine."
For ordinary people who are vaccinated with hepatitis B vaccine, they should also be tested for hepatitis B surface antibody for 5-10 years. If the hepatitis B surface antibody decreases, they should also be strengthened or re-vaccinated with hepatitis B vaccine.
Director Jiang also mentioned, "In recent years, great changes have taken place in hepatitis B vaccine in China, from inactivated/attenuated vaccine in 1970s to gene recombination vaccines now. Compared with inactivated/attenuated vaccine, the side effects of gene recombination vaccines are relatively few, and for most people, hepatitis B vaccine has no absolute contraindication. However, patients who are allergic to vaccines during the period of cold and fever should choose not to be vaccinated with hepatitis B vaccine.
"China has a large population base and a large number of hepatitis B vaccinations. We are very experienced in the quality and efficiency of hepatitis B vaccination and have strong safety. In general, hepatitis B vaccine is a key measure to reduce hepatitis B infection. " Director Jiang stressed.
Hepatitis B vaccination targets are mainly newborns.
The sooner you get the hepatitis B vaccine, the better. The guideline suggests that the target of hepatitis B vaccination is mainly newborns, followed by infants, uninmunized people under the age of 15 and high-risk people. Hepatitis B vaccine needs to be inoculated with 3 shots in the whole process, that is, according to the procedures of 0, 1 and 6 months, after the first shot, the second and third shots are inoculated at 1 month and 6 months.
The guideline also added the first dose of hepatitis B vaccine and hepatitis B immunoglobulin as soon as possible within 12 hours of birth for premature infants and low-birth-weight infants born to mothers with unknown HBsAg. After one month of age, complete hepatitis B vaccine immunization according to the procedures of 0, 1 and 6 months.
Director Jiang emphasized: "The purpose of this is to reduce the infection risk of premature infants and low-energy infants when the mother’s infection is unknown."
Improve the success rate of mother-to-child blocking
Hepatitis B is mainly transmitted through mother-to-child, blood and sex. Before the implementation of neonatal hepatitis B vaccine immunization program in China, HBV was mainly transmitted from mother to child. Newborns with HBsAg positive mothers should be vaccinated with hepatitis B vaccine and hepatitis B immunoglobulin within 12 hours of birth for mother-to-child blocking. At present, the success rate of mother-to-child blocking has reached more than 95%, but 5% of children still fail to block mother-to-child.
Director Jiang explained: "The failure of mother-to-child blocking is mainly related to the following three points. First: the mother’s hepatitis B virus load is very high; Second, the mother is positive for HBsAg and E antigen; Third: the vaccination is not standardized, parents do not pay attention to it, and the second and third doses of hepatitis B vaccine are not vaccinated in time. "
For newborns who have failed mother-to-child vaccination, the hepatitis B vaccination should be completed again according to the procedures of 0, 1 and 6 months, and the hepatitis B surface antibody of the children should be monitored after 1-2 months. If no antibody is produced, the success rate should be improved by increasing the number and dosage of vaccination.
In addition, Director Jiang also introduced: "With the progress of the times, there are better ways to block mother and child. The’ Zero Mother-to-Child Transmission Project of Hepatitis B’ was launched in China, and even Hunan Province joined the plan. Improving the mother-to-child blocking rate can also monitor the HBV-DNA titer at the 24th week of pregnancy. When the HBV-DNA titer is greater than 105UI/mL, the pregnant mother will be given antiviral treatment, and then the newborn will be given hepatitis B vaccine and hepatitis B immunoglobulin vaccination plan. Common antiviral drugs are tenofovir, entecavir and lamivudine. Among them, tenofovir can be used not only during pregnancy, but also during lactation. "
On July 28th, World Hepatitis Day, a message to hepatitis B patients.
(Click on the video to view)
Viral hepatitis includes hepatitis A, B, C, D and E. Hepatitis C is curable, and hepatitis B is also controllable, preventable and treatable.
For the majority of patients with hepatitis B, once they find themselves infected with HBV, they should go to the hospital for regular examination and make standardized diagnosis and treatment under the guidance of doctors.
For patients with hepatitis B infection in their immediate family members, they should also go to the hospital actively to prevent aggregation transmission and get diagnosis and treatment in time.
For ordinary people, they should actively go to the hospital for examination, and actively replant or inoculate hepatitis B vaccine when there is no hepatitis B surface antibody or the hepatitis B surface antibody is low.
For medical staff, we should increase publicity, not only for patients, but also for doctors in non-infectious departments and non-hepatology departments, deepen the awareness of people with viral hepatitis and actively treat viral hepatitis.
Only with the joint efforts of all, can we achieve the goal of eliminating viral hepatitis in 2030 proposed by the World Health Organization.
Expert introduction
Director Jiang Yongfang
Director of Hunan Engineering Research Center for New Artificial Liver
Director, Department of Infectious Diseases/Department of Infectious Diseases/Liver Disease Center, Xiangya Second Hospital, Central South University
Deputy Director, Institute of Liver Diseases, Central South University
Member of Infectious Diseases Physician Branch of Chinese Medical Doctor Association.
Member of Fatty Liver and Alcoholic Liver Disease Branch of Chinese Medical Association.
Member of end-stage liver disease group of liver disease branch of Chinese Medical Association.
Member of Bacteriology and Fungology Section, Infectious Diseases Branch of Chinese Medical Association.
Young Member of the Seventh Hepatology Branch of Chinese Medical Association
Standing Committee member of liver disease professional Committee of China Research Hospital Association
Member of the Professional Committee of Liver Diseases of China Medical Education Association
Vice Chairman of Liver Disease Professional Committee of Hunan Medical Association
Vice Chairman of Infectious Diseases Professional Committee of Hunan Medical Association
Deputy Editor-in-Chief of GUT Chinese Liver Disease Special Issue.
Engaged in the diagnosis and treatment of liver and infectious diseases, as well as pathological diagnosis of difficult liver diseases.
Mainly engaged in the study of oxidative stress involved in the pathogenesis of viral hepatitis, fatty liver and liver fibrosis. He presided over 4 national-level projects such as the National Natural Science Foundation, the "Twelfth Five-Year Plan" and "Thirteenth Five-Year Plan" sub-projects. The first finisher won the second prize of Hunan Natural Science Award, the third prize of Science and Technology Progress Award and the third prize of Medical Science and Technology Award. Published 30 SCI papers including GUT and HEPATOLOGY.
References:
[1] Wang Guiqiang, Duan Zhong Ping, Wang Fusheng, et al. Guidelines for prevention and treatment of chronic hepatitis B (2019 edition) [J]. Journal of Practical Liver Diseases, 2020.
This article starts: medical digestive liver disease channel
Author: Jiu Lu
Audit of this article: Director Jiang Yongfang, Department of Infectious Diseases, Xiangya Second Hospital, Central South University.
Editor in charge: XU
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Original title: "Hepatitis B vaccine is not lifelong immunization, please keep this vaccination guide! | Interview with Professor Jiang Yongfang
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