1. Vaccines target diseases
Hectomy B, is a widely popular and harmful infectious disease caused by hepatitis B virus infection. Infectious diseases caused by hepatitis B virus infection with acute or chronic liver inflammation as the main clinical manifestation. Acute hepatitis B or chronic hepatitis B acute attacks, common fatigue, loss of appetite, nausea and oil disgust, and pain in the upper right abdomen. Some patients can see jaundice , fever, and liver function damage. The persistence or recurrence of inflammatory damage in liver parenchymal cells is an important factor in the progression of chronic hepatitis B virus infection to cirrhosis or even liver cancer . About 887,000 people die from hepatitis B virus infection every year worldwide, of which the mortality rates of cirrhosis and liver cancer account for 30% and 45% respectively. It has brought heavy economic burden to patients, families and society, and is an important reason why many families become poor and fall back into poverty due to illness. At present, there is no cure for hepatitis B, so it is very important to prevent hepatitis B. The World Health Organization advocates: vaccination with hepatitis B is the safest, effective and economical way to prevent hepatitis B.
Source of infection: is mainly patients and virus carriers, including patients with acute and chronic hepatitis B and virus carriers. Children themselves lack immunity to hepatitis B virus and are more likely to be infected with hepatitis B virus.
Transmission route: First, it is transmitted through blood, mainly including blood transfusions and blood products, unclean injection needles, non-strict disinfection acupuncture, dental and surgical instruments and other medical behaviors, tattoos, eyebrow penetration, ear and eye penetration, double eyelids, scraping face and other harmful cosmetic behaviors; the second is mother-to-child transmission, which refers to a way for mothers carrying hepatitis B virus to spread hepatitis B virus to babies during pregnancy and delivery. If specific preventive measures are not taken, about 40% of mothers who are positive for the surface antigen of hepatitis B virus will be transmitted to the newborn, and about 90% of mothers who are positive for the surface antigen of the hepatitis B virus and e antigen of the hepatitis B virus will be transmitted to the infant; third, it is sexual transmission, which can spread the hepatitis B virus through semen and vaginal secretion.
2. Vaccine introduction
3The hepatitis B vaccines approved in my country are recombinant yeast hepatitis B vaccine and recombinant Chinese hamster ovary (CHO) cell hepatitis B vaccine , and the dose is divided into 10μg, 20μg and 60μg.
Another type is hepatitis A and B combined vaccine. Recommended for 1 years old and above hepatitis A and hepatitis B susceptible to 3 doses, 1 dose per 0, 1, and 6 months, and intramuscular injection. It is recommended to vaccinate patients who need lifelong treatment of blood products, gay men and men, staff who come into contact with non-human primates, intravenous drug users, and patients with chronic liver disease at high risk of infection.
33. Vaccine effect
For patients with normal immune function, the serum anti-HBs ≥10 mIU/mL was tested 1-3 months after completing the 3 doses of hepatitis B vaccine in full. It is a reliable sign of vaccination to prevent hepatitis B virus infection and has a long-term protective effect. For immunodeficiency who are continuously exposed to the HBV-infected environment, it is recommended to test serum anti-HBs once a year and strengthen immunity to maintain anti-HBs ≥10 mIU/mL to obtain continuous protection. By receiving hepatitis B vaccine, especially routinely vaccinating newborns, many hepatitis B endemic countries have effectively reduced the incidence and prevalence of hepatitis B.
IV. Immunization program
(I) Applicable objects
2 All people who are not infected with hepatitis B virus and have not obtained hepatitis B immunity can receive hepatitis B vaccine. The earlier the hepatitis B vaccine, the better. Therefore, the main targets for the hepatitis B vaccine are newborns, followed by infants and young children, unimmunized and high-risk groups under the age of 18. (II) Dosage, dose and interval Hepatitis B vaccine requires 3 shots throughout the whole process. According to the procedure of 0, 1 and 6 months, that is, after the first shot of the vaccine is vaccinated, the second and third shots are injected at 1 month and 6 months. 1. Newborn vaccination: The first hepatitis B vaccine should be vaccinated as soon as possible within 24 hours of birth. (1) Newborns of HBsAg-negative mothers: 10 μg of recombinant yeast hepatitis B vaccine or CHO cell hepatitis B vaccine per shot. (2) Newborns of HBsAg-positive mothers: intramuscularly inject 100 IU hepatitis B immunoglobulin (HBIG), and the first hepatitis B vaccine was injected at different (limb) sites at the same time; 10 μg of recombinant yeast hepatitis B vaccine or 20 μg of CHO cell hepatitis B vaccine were given each shot. It is recommended to undergo HBsAg and anti-HBs tests at 1-2 months after receiving the third hepatitis B vaccine. If HBsAg is negative and anti-HBs is <10> (3) Newborns born to a mother with HBsAg positive or unknown, the first hepatitis B vaccine should be vaccinated as soon as possible within 12 hours of birth; if the newborn weighs less than 2,000g, the first hepatitis B vaccine should be vaccinated as soon as possible. After 1 month of age, 3 hepatitis B vaccines should be completed according to the 0, 1 and 6 months procedures. 2. Adult vaccination: 20 μg of recombinant yeast hepatitis B vaccine or CHO cell hepatitis B vaccine each time. Adults with low immune function or no response can increase vaccination doses and injections, and those who have no response to the 0, 1 and 6 months of procedures can receive 3 more doses of hepatitis B vaccine. Specific operations are performed according to the instructions for the selected applicable vaccine. (III) Inoculation method Neonatal inoculation is intramuscular injection on the lateral upper arm or the anterior and lateral middle thigh; children and adults are intramuscular injection on the central deltoid muscle of the upper arm. 5. Vaccination contraindications Hepatitis B vaccine ( Saccharomyces cerevisiae and Hansun yeast) are: ( 1) Those who are known to be allergic to any ingredients contained in this vaccine, including excipients and formaldehyde; (2) people suffering from acute diseases, severe chronic diseases, and acute attacks and fevers of chronic diseases; (3) women during pregnancy; (4) people suffering from uncontrolled epilepsy and other progressive neurological diseases. The contraindications for the hepatitis B vaccine (CHO cells) are: (1) Those who are known to be allergic to any ingredients contained in this vaccine, including excipients, formaldehyde and the antibiotics contained in this vaccine; (2) People suffering from acute diseases, severe chronic diseases, and acute attacks and fevers of chronic diseases; (3) women during pregnancy; (4) People suffering from uncontrolled epilepsy and other progressive neurological diseases. 6. Other related matters (I) Critical neonates: such as extremely low birth weight (birth weight less than 1500g), severe birth defects, severe asphyxiation, respiratory distress syndrome, etc. Vaccination should be done as soon as possible after the vital signs are stable. (II) Accidental exposure: refers to the person whose skin or mucosa contacts the blood or body fluids of a patient with an unknown HBsAg or whose skin or mucosa is impaired by a needle contaminated. 1. If you have been vaccinated with the hepatitis B vaccine and have been found to be positive for anti-HBs (≥10 mIU/mL), you do not need to be vaccinated again. 2. If you have not received the hepatitis B vaccine, or if you have received the hepatitis B vaccine, but have unknown anti-HBs10 mIU/mL or anti-HBs levels, you should immediately inject HBIG 200-400 IU, and you should receive one hepatitis B vaccine (20 μg) at different sites at the same time, and the second and third hepatitis B vaccines (20 μg) after 1 month and 6 months respectively. 7. Other issues of concern (I) Can hepatitis B mothers breastfeed?
First, let everyone know a clear answer: Hepatitis B mothers, regardless of their infectiousness, can breastfeed babies who have been routinely vaccinated with hepatitis B vaccine and hepatitis B immunoglobulin.
studies show that breastfeeding will not increase the risk of hepatitis B infection in babies born to hepatitis B mothers. Some mothers are worried that if the nipples are damaged, will it increase the risk of hepatitis B infection after birth? Theoretically speaking, the mother's nipples are damaged and the baby has oral/gastrointestinal wounds at the same time, that is, the mother's body fluids with hepatitis B virus are exchanged with the child's body fluids. At the same time, the mother's hepatitis B virus concentration is very high and the baby is not immune to the hepatitis B virus, so postnatal infection may occur. Therefore, children in mothers of hepatitis B should regularly monitor the complete set of hepatitis B to evaluate whether the child produces hepatitis B surface antibodies (HBsAb) and its titer levels to ensure that the baby obtains an effective immune response and is resistant to the risk of infection in daily life.
(II) The baby was detected as soon as hepatitis B virus was born. Can it be said that it was a failure to block?
In order to diagnose or distinguish intrauterine infections and postpartum infections of babies born to hepatitis B mothers, some doctors will immediately draw venous blood or umbilical cord blood when the baby is born to test the baby for five hepatitis B items.
So what should new mothers do when the baby is tested for venous blood or umbilical cord blood when he is born?
In fact, when hepatitis B mother gave birth to a baby, due to strong contractions, a small amount of viral components will flow back into the fetus, resulting in some components of hepatitis B virus being detected in the blood after the baby is born. However, these hepatitis B virus components contaminated from the mother's body to the newborn's body only exist in a free state in the blood and do not really infect the baby's liver cells. As long as the baby is injected with hepatitis B immunoglobulin immediately after birth (within 12 hours), it can effectively neutralize the hepatitis B virus from the mother's contamination.
8. Hepatitis B vaccination promotion video
Basic public health service publicity platform, like 8
