Problem description:
I am 26 years old now, because I often eat out. Last time my friend asked me if I had been vaccinated against hepatitis B, I went to the hospital for examination and all the indicators were negative.
Do I need to be vaccinated against hepatitis B now?
If you want to call, which hospitals should you call? How many injections are given in a course of treatment? How long will it take? How much is each injection? How long does it take after a course of treatment? Thank you.
Analysis:
Hepatitis B vaccine prevention has been included in the planned immunization program, but its vaccination coverage rate is not high. Many people are not clear about the vaccination methods and precautions of hepatitis B vaccine, so it is very necessary to briefly introduce it here.
First, why do you want to play hepatitis B vaccine?
Hepatitis B vaccine can successfully prevent the infection of hepatitis B virus. Newborns are vaccinated with hepatitis B vaccine at birth, which basically guarantees that they will not be infected with hepatitis B in the future.
The existing liver cirrhosis and liver cancer are mostly developed from hepatitis B. The successful prevention of hepatitis B is actually the first shot to prevent liver cirrhosis and liver cancer. At present, hepatitis B vaccine is relatively cheap, a few dollars each, and the public can accept it.
Second, what kind of hepatitis B vaccine should I choose?
At present, genetic engineering hepatitis B vaccine is widely used, and the blood-borne vaccine used in the past has been basically eliminated (because it is suspected of causing blood-borne diseases and wasting a lot of plasma). Genetic engineering hepatitis B vaccine is a recombinant plasmid containing hepatitis B surface antigen gene obtained by modern genetic engineering technology, which can be used to prevent all known subtypes of hepatitis B virus infection. At present, genetically engineered hepatitis B vaccines include hepatitis B recombinant DNA yeast vaccine and recombinant vaccinia virus vaccine, each with a dose of 5 micrograms.
Third, what is the correct way to use hepatitis B vaccine?
(1) If neither of the newborn's parents has hepatitis B, the newborn should be given 1 intramuscular injection of genetically engineered hepatitis B vaccine as soon as possible (within 8 hours) after birth, and the injection site is the deltoid muscle of the upper arm (children and adults can). 1 Give it to 1 after one month, and give it to 1 after six months. Children and adults need to be tested before vaccination. If all three lines of hepatitis B are negative and transaminase is normal, hepatitis B vaccination can be carried out according to 0,/kloc-0, and 6 schemes. The success rate of immunization is above 90%, and the sign of successful immunization is that hepatitis B surface antibody turns negative, and the protection time is generally more than 2 years. Inoculators can regularly review the hepatitis B triple system, as long as the surface antibody still exists, which proves that the immunity is still the same. (2) For newborns whose mothers are positive for simple surface antigen, using hepatitis B vaccine alone can achieve satisfactory results. The use method of hepatitis B vaccine is still 0, 1 6. It is reported that the first dose can be 2 (10 μ g /l mL), and the effect is better. (3) For newborns whose mothers are positive for hepatitis B virus surface antigen and E antigen, it is best to use hepatitis B immunoglobulin in combination with high titer hepatitis B vaccine. The specific method is that newborns are injected with high-titer hepatitis B immunoglobulin twice (65,438+0 immediately after birth, 65,438+0 months after birth, 200 international units each) and hepatitis B vaccine three times (65,438+00 micrograms each time, 65,438+0 times each after birth); In addition, hepatitis B immunoglobulin 1 was injected immediately after birth, and hepatitis B vaccine was injected three times (each time 15 μ g, immediately after birth 1, and in June and June 1 respectively), and the success rates of both schemes were above 90%.
4. What should I do if I don't produce antibodies after vaccination?
(1) Some people produce antibodies late, which is called slow reaction. For this, we can inject 1~2 injections or re-vaccinate, and the dose can be increased appropriately. (2) Immunization programs of 0, 1, 2 and 12 months can be adopted. (3) At the same time of hepatitis B vaccination, use a small dose of interleukin -2. (4) BCG or vaccinia vaccine can increase the immune response to hepatitis B vaccine and can be used in combination.
5. After vaccination, how long will it take to get vaccinated again?
The antibody level produced after hepatitis B vaccination decreased gradually with time. Generally, 97% people can detect the surface antibody by injecting it 3 times 1 month. Maintain this level in the second year; In the third year, the antibody titer decreased to about 74%. Whether it is necessary to vaccinate again is mainly to determine the titer of hepatitis B surface antibody before deciding when to vaccinate again. Hepatitis B surface antibody titer less than or equal to 10 international unit/ml should be vaccinated within half a year. The antibody titer is greater than 10 IU/ml, and it can be replanted within 6 years. Most domestic scholars suggest that it is better to strengthen 1 time within 3 years after immunization.
6. Can hepatitis B vaccine be used with other vaccines?
Hepatitis B vaccine can be inoculated at the same time with meningococcal vaccine, BCG vaccine, DTP vaccine, spinal cord gray matter vaccine and Japanese encephalitis vaccine, and the vaccination procedures are carried out in the order required by the planned immunization. But it is best not to use hepatitis B vaccine and measles vaccine at the same time.
Seven, accidental contact with hepatitis B virus how to play hepatitis B vaccine?
(1) Inject hepatitis B immunoglobulin (within 24 hours) and then inoculate hepatitis B vaccine (after inoculation 1 week) for contacts who have not been vaccinated with hepatitis B vaccine. (2) Contacts who have been vaccinated, but have not been fully immunized, should be fully immunized according to the hepatitis B vaccine immunization program after being injected with hepatitis B immunoglobulin. (3) Contacts who have been vaccinated and have produced hepatitis B surface antibodies should be judged according to their antibody levels. If the level of hepatitis B surface antibody is enough, there is no need for treatment; If the level is not enough, it is necessary to strengthen the injection of 1 needle vaccine; Those who do not respond to the first immunization should be injected with hepatitis B immunoglobulin and hepatitis B vaccine 1 needle as soon as possible.
8. Will hepatitis B vaccine infect other infectious diseases?
Vaccination against hepatitis will not cause other hepatitis, nor will it infect other diseases. Hepatitis B vaccine has strict quality standards in the production process, and many of them can kill pathogenic microorganisms including HIV in blood, which is safe and reliable through clinical observation. It is worth mentioning that using unqualified products, such as injecting damaged or deteriorated vaccines, or using syringes or needles in the process of injection, can cause hepatitis or other infectious diseases. There are also some people who are recessive infected. The virus is in a low-level replication state, and the "two and a half" test is normal. It is necessary to detect virus (HBVDNA positive) by RNA proliferation method. Such people will not form surface antibodies after vaccination.
Nine, if in remote areas, it is still impossible to achieve universal vaccination of hepatitis B vaccine?
At least the following high-risk and susceptible groups of hepatitis B virus should be vaccinated: all newborns and kindergarten children; Workers engaged in dangerous occupations (infectious diseases, stomatology, hemodialysis rooms, blood stations, nurses, etc.). ); People who use blood products; Newly enlisted soldiers; Patients before organ transplantation; Those who need long-term use of immunosuppressants; Family members and sexual contact of hepatitis B virus carriers.
X. Is it necessary for patients with hepatitis B to get hepatitis B vaccine?
Hepatitis B vaccine has no preventive effect on hepatitis B patients and hepatitis B virus carriers. No amount of hepatitis B vaccine will produce the corresponding protective antibody-hepatitis B virus surface antibody, which is just a waste of vaccine and funds. For people who have acquired effective protective antibodies naturally because of their previous infection with hepatitis B virus (hepatitis B surface antibody was positive in the "two and a half" test), there is no need to vaccinate again, but there will be no adverse side effects after vaccination, and the level of hepatitis B surface antibody may increase. If it is an acute hepatitis B patient, after active treatment, it can be completely cured and recovered. After examination, the "two and a half" surface antigens of hepatitis B virus turned negative, only the core antibody was positive, and the protective hepatitis B virus surface antibody could never be produced by itself. In this case, you can inject hepatitis B vaccine to promote the production of surface antibodies, so that you will not get hepatitis B again in the future.
Most hepatitis B virus carriers in China come from newborns and childhood infections. It can be seen that the prevention of newborns is particularly important, and all newborns should be vaccinated against hepatitis B. This is because newborns have the lowest immunity to hepatitis B virus and their immune function is not perfect. Once infected, it is difficult to remove the virus and become a carrier of hepatitis B virus. Secondly, preschool children should also be vaccinated. Third, the spouses of HBsAg-positive people and other people who are engaged in occupations at risk of contracting hepatitis B, such as people who are in close contact with blood, medical personnel, hemodialysis patients, etc. Fourth, people who are accidentally infected with hepatitis B virus should be vaccinated against hepatitis B if they are accidentally stabbed by a needle contaminated with HBsAg positive blood, or if HBsAg positive blood splashes on the conjunctiva or oral mucosa.
Newborns with HBsAg positive mothers should be vaccinated with hepatitis B immunoglobulin and hepatitis B vaccine at the same time. The protection rate of 97.438+03% can be achieved by injecting two kinds of hepatitis B immunoglobulins and three kinds of hepatitis B vaccines (1 and 1 respectively in February and July after birth).
Newborns whose mothers are HBsAg negative can use hepatitis B vaccine alone. Generally, once 10μg and three injections (immediately after birth, 1 month, 6 months) can achieve satisfactory preventive effect.
There are two ways to vaccinate preschool children. One is to draw blood to check HBsAg and anti-HBs, both of which are negative before vaccination. The other method is direct inoculation without serological examination, and the scheme of injecting 1 0 μ g in 0,1and June respectively is adopted.
Since most adults have been exposed to hepatitis B virus, only a few people are susceptible. HBsAg and anti-HBs should be tested before inoculation, and then inoculation should be carried out when both of them are negative. Plans of 0, 1 and 10μg can be adopted in June.
In case of accidental infection, hepatitis B immunoglobulin 10IU/kg (200IU 3 ~ 4 for adults) should be injected immediately (within 24 hours, the sooner the better), and then hepatitis B vaccine should be inoculated in June two weeks later according to the scheme of 0, 1,10μ g.