Hepatitis B is contagious and has the potential to develop into terrifying diseases such as cirrhosis and liver cancer, which makes everyone feel disgusted. Fortunately, the hepatitis B vaccine is a powerful weapon for children They provide protection. After receiving the hepatitis B vaccine, most children can produce antibodies, but after a period of time, the antibody level may gradually decline, or even undetectable. Do I need a booster shot? Today, we will sort out the frequently asked questions about the hepatitis B vaccine.
I. What level of antibody is sufficient for hepatitis B vaccination? The conventional hepatitis B vaccine requires three doses, and the vaccination schedule is from 0-1-6 months, such as the first dose of hepatitis B vaccine on March 1, and the second dose on April 1 Vaccine, the third dose of vaccine will be given on September 1. Hepatitis B surface antibody titers are usually detected 1 to 2 months after the completion of the third dose of vaccination. When the hepatitis B surface antibody titer is greater than or equal to 10mIU/ml, it means that a sufficient immune response has been generated strong>[1] . 95% of healthy children and young adults can produce sufficient hepatitis B surface antibodies after receiving three doses of hepatitis B vaccine, but with age, the response rate will gradually decline, and 86% at the age of 30 to 39 years Only 47% of people aged 50-59 can produce ≥10mIU/ml of hepatitis B surface antibody[2].
Second, if the antibody has weakened or disappeared, do I need to receive a booster vaccine? After receiving the hepatitis B vaccine, after sufficient hepatitis B surface antibody is produced, the titer of hepatitis B surface antibody will gradually decrease over time, or even turn negative. However, the specific immunity of our body includes humoral immunity and cellular immunity. After the hepatitis B vaccine, in addition to the production of hepatitis B surface antibodies(humoral immunity)< span>, and also generate immune memory cells against hepatitis B(cellular immunity). Over time, even if HBsAg gradually diminished(HBsAb titers decreased to <10mIU/ml)or disappeared(negative ), most of the cellular immune function against hepatitis B still exists. If a virus attacks the body, most people still have resistance to hepatitis B. By activating immune memory cells, it quickly triggers a memory response and protects us from hepatitis B. According to recent research, the protective effect of hepatitis B vaccine can last for up to 30 years[1,3,4]. Therefore, as long as sufficient hepatitis B surface antibodies have been produced, the general population does not need routine booster vaccines.
3. In which cases should a booster vaccine be administered? As we mentioned just now, the immune memory against hepatitis B mainly depends on the healthy immune function of the body, and if it is a population with immunodeficiency, living with hepatitis B patients Booster vaccines are required if repeated exposure to hepatitis B virus is possible. For example, patients with recognized renal failure requiring hemodialysis should be tested for hepatitis B surface antibody titers every year. If the level of hepatitis B surface antibody falls below 10mIU/mL, booster vaccination is required [5]. Similarly, other immunocompromised populations, such as AIDS patients, hematopoietic stem cell transplant recipients, or those receiving chemotherapy, should also monitor HBV surface antibody levels annually if they are at risk of repeated HBV exposure. When it falls below 10mIU/mL, a booster vaccine is required[6].
4. What should I do if I don’t produce enough antibodies after receiving hepatitis B vaccine? Some people did not produce enough hepatitis B surface antibodies after receiving three doses of hepatitis B vaccine(hepatitis B surface antibody titer<10mIU/ml)< /span>, there may be several reasons for this:
- The older you are, the lower the response rate.
- Obesity, smoking, and men had slightly lower response rates.
- Liver cirrhosis, chronic renal failure, organ transplant recipients, children with celiac disease, and immunosuppressed patients have significantly lower response rates. The vaccine response rate of standard doses is 50%-60%[5].
- Unresponsiveness due to genetic and genetic causes.
- Non-response due to technical errors, such as intramuscular injections in the buttocks or vaccine transport or improper storage conditions.
No matter what the cause of non-response, as long as the hepatitis B surface antibody titer is less than 10mIU/ml after the hepatitis B vaccine, it is recommended to re-vaccinate the hepatitis B vaccine. Check again 2-3 months after the three shots of hepatitis B vaccine. If there is still no response after three additional doses of hepatitis B vaccine, further vaccination is no longer recommended. If these people are exposed to the blood or body fluids of hepatitis B patients, it is recommended to use Hepatitis B Immunoglobulin[7].
5. Do you need to worry if you have not received the hepatitis B vaccine? For those who have not been vaccinated against hepatitis B, they may also worry about whether they will be infected with hepatitis B; Become a chronic hepatitis B virus carrier. The consequences of hepatitis B virus infection are closely related to the age at the time of infection, and 90% of perinatal infection will become chronic hepatitis B virus infection. 20%-50% of infections at the age of 1-5 will become chronic, and more than 95% of people infected with the infection will heal themselves in adulthood and will not become chronic[8] . The process of infection in adults is mostly recessive and nothingSymptoms are only positive for hepatitis B surface antibody or hepatitis B core antibody when the five items of hepatitis B are detected, indicating that they have been infected with hepatitis B virus in the past and have healed themselves. So, ordinary people don’t have to worry too much. If someone in the family has hepatitis B, vaccinating all other family members is the best protection for them.
References
[1]Hadler SC, Francis DP, Maynard JE, et al,Long-term immunogenicity and efficacy of hepatitis B vaccine in homosexual men.N Engl J Med. 1986;315(4):209.
[2]Poland GA,Hepatitis B immunization in health care workers. Dealing with vaccine nonresponse. Am J Prev Med. 1998;15(1):73.
[3] Bruce MG, Bruden D, Hurlburt D, et al. Antibody Levels and Protection After Hepatitis B Vaccine: Results of a 30-Year Follow-up Study and Response to a Booster Dose. J Infect Dis. 2016;214(1):16.
[4]Simons BC, Spradling PR , Bruden DJ, et al. A Longitudinal Hepatitis B Vaccine Cohort Demonstrates Long-lasting Hepatitis B Virus (HBV) Cellular Immunity Despite Loss of Antibody Against HBV Surface Antigen. J Infect Dis. 2016 Jul;214(2):273-80.
[5]Propst T, Propst A, Lhotta K, et al. Reinforced intradermal hepatitis B vaccination in hemodialysis patients is superior in antibody response to intramuscular or subcutaneous vaccinat ion. Am J Kidney Dis. 1998;32(6):1041.
[6]https://www.cdc.gov/hepatitis/HBV/HBVfaq.htm (Page last reviewed: May 16 , 2019).
[7] UpToDate Clinical Consultant: Hepatitis B Virus Vaccination.
[8]UpToDate Clinical Consultant: Epidemiology, Transmission and Prevention of Hepatitis B Virus Infection.
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After this summer vacation, many children will start to enter the kindergarten, and parents may also encounter many things they have never encountered before. I don’t know how to deal with problems, such as those in the picture below. (swipe up and down to view)The above content is the content of Dr. Xu Guifeng’s column in Yihe’s “Baby’s Enrollment Collection“, if necessary, you can pass Learn more about the QR code below.