Hepatitis B vaccination guide in China

Hepatitis B vaccine is recommended for all people who are not infected with hepatitis B virus and whose hepatitis B surface antibody (anti-HBs) is negative or has a titer lower than 10mIU/ml.； Newborns need to complete the first dose of vaccination within 24 hours after birth. Newborns born to mothers who are positive for hepatitis B surface antigen (HBsAg) need to be injected with hepatitis B immunoglobulin at the same time to complete the blockade. ； General people who have been infected with hepatitis B virus (HBsAg positive) or whose anti-HBs titer is higher than 100mIU/ml do not need to be vaccinated again.

I have been helping at the vaccination site at a community health service center for almost half a year, and the most common question I have encountered is “I was vaccinated when I was a child, do I still need to take it up now?” ”Last week, an Internet girl born after 1995 rushed in with a physical examination report and said that the antibody titer was only 8mIU/ml. She was afraid that the test would be useless and that she would not be infected. In fact, there is really no need to worry about it. As long as the hepatitis B surface antigen is negative and the titer is not enough, it will be fine. A shot of 20 μg of the recombinant vaccine only costs a few dozen yuan, which is cheaper than drinking three cups of milk tea. The protection can last for at least ten years.

When it comes to whether to take booster shots, there is indeed no completely unified view in the industry. The guidelines updated in 2023 by the Chinese Center for Disease Control and Prevention clearly state that as long as the anti-HBs is ≥10mIU/ml, the general population does not need to be strengthened. Even if the subsequent titer slowly decreases, the memory function of the immune system can be maintained for at least 15 years. When encountering the hepatitis B virus, antibodies will be quickly awakened, which is completely preventable. However, many infectious disease clinicians and colleagues in the hospital's infectious disease department will have another suggestion: if you are medical staff and disease control personnel who are often exposed to blood, patients with blood diseases who need blood transfusions for a long time, people who take immunosuppressants, or your sexual partners are infected with hepatitis B, as long as the titer is between 10-100mIU/ml, it is best to take a supplementary dose. There is no harm in having an extra layer of protection. Previously, a young girl who just joined the laboratory test department was found to have an antibody level of 22mIU/ml. The hospital's infectious disease department directly asked her to take a retest. This is the reason. There is no absolute right or wrong. It just depends on your exposure risk.

The currently commonly used hepatitis B vaccines are all recombinant and inactivated, and are extremely safe. They are divided into three types: recombinant yeast, Hansenula yeast, and CHO cells. The difference in effectiveness is very small. Just use whichever vaccine you can get an appointment with. In the past, I encountered parents who were allergic to yeast and were afraid to vaccinate their children. In fact, it is perfectly fine to choose the CHO cell vaccine. There is no need to wait for a specific vaccine. It is not worth the delay in vaccination time.

The vaccination program is not limited to 0-1-6. The conventional 3-injection method does have the highest antibody positive conversion rate and is suitable for people with weak immune function, such as patients who have been taking hormones for a long time and people infected with HIV. It is safer to complete the three injections according to the procedure. But now there is also a high-dose vaccine of 60 μg, which only requires one injection. It is especially suitable for office workers who often travel and cannot spare time to run three times. Many studies have shown that adults with normal immune function take one injection of 60 μg, and the antibody positive conversion rate is not much different from that of three injections of 20 μg, saving a lot of trouble.

There are also a few special situations that people have asked a lot about. Let me explain them together: Pregnant women who are found to be fully negative for antibodies can definitely be vaccinated. The inactivated vaccine will not affect the fetus. If there is a hepatitis B carrier in the family, it is safer to be vaccinated as early as possible.； Physiological jaundice in newborns does not affect vaccination at all. There is no need to wait for the jaundice to subside before vaccination. Previously, a parent had to wait for half a month before bringing his baby for the first injection. In fact, it increased the risk of exposure and was completely unnecessary. ； Someone also asked if you can get hit after drinking alcohol? As long as you are not too drunk that day, a little bit of drinking will have no effect at all, so there is no need to change the time.

Don’t think, “Since no one in my family has hepatitis B, I don’t need to get vaccinated.” Last year, I met a college student who had just graduated. He got his eyebrow tattooed in a small studio while traveling and used tools that were not thoroughly sterilized. He was infected with hepatitis B and is still taking antiviral drugs. Hepatitis B is transmitted through blood, mother-to-child, and sex. It is not just a family inheritance that can cause the disease. Spending dozens of yuan on a vaccine to avoid facing the risk of cirrhosis and liver cancer in the rest of your life is a good deal no matter how you calculate it.

Finally, I would like to mention that there is no need to rush to check for antibodies after the vaccine. If you really want to confirm whether you have been vaccinated, wait 1-2 months after the third injection before checking. Otherwise, the antibodies have not risen yet, and the check will be in vain. The general population does not need to have annual physical tests for antibodies. A test every 10 years is enough. For high-risk groups, a test every 3 to 5 years is enough. Don’t listen to the online scammers who say “you must maintain a strong positive to be safe”.