I was obviously given hepatitis B vaccine when I was a child, but why can’t I detect antibodies when I go to a physical examination now? This is a question from many people, but in fact, the disappearance of the antibody does not mean that it has no protection. So do we need to get a hepatitis B vaccine?
my country has fully implemented the newborn hepatitis B vaccination in 1992. Four years later, found that the chronic infection rate of newborn hepatitis B decreased to 0.96%. In the next 20 years, my country has saved at least 80 million children from being infected with the hepatitis B virus by vaccinating with hepatitis B virus. The number of carriers of the surface antigen of hepatitis B virus is less than 20 million. This is a very effective way to prevent hepatitis B. However, the group of children who were vaccinated with hepatitis B vaccine that year went for physical examination when they were adults, but many found that did not have hepatitis B antibodies. What's going on?
% to about 3% of people who get hepatitis B vaccine will not produce antibodies
Usually after vaccination, protective hepatitis B antibodies will be produced in the human body. However, medicine does not have 100% of things. It is known that 1-3% of people who get hepatitis B vaccine but do not produce antibodies. It is mainly due to physical constitution, a few people have poor congenital reactions to certain antigens.
When a person was born, there were many lymphocytes in his body. In theory, it corresponds to the antigen that currently exists in the world. It is like raising various troops and can deal with all kinds of invading foreign enemies. Therefore, the most perfect operating state of the immune system is that there are soldiers who specialize in dealing with different foreign enemies, but they will not attack their own troops.
But this process may be flawed, and some people just cannot produce antibodies based on vaccines. In the past, I encountered this situation, I received another 3 doses of hepatitis B vaccine. Another method is to use high-dose hepatitis B vaccine or a new generation of hepatitis B vaccine. Compared with the most commonly used vaccines at present, the protein of the new generation of hepatitis B vaccine presents a total antigen, and the extra segment may have antigens recognized by lymphocytes. However, few people have this need, so the new generation of hepatitis B vaccine is currently rarely used in major medical institutions.
Hepatitis B antibody will disappear with age
In addition to a few people's constitutional reasons, even if they are vaccinated, it is normal to not be able to detect hepatitis B antibodies, because newborns complete three hepatitis B vaccinations at 24 hours a day, 1 month or 6 months of birth. However, the hepatitis B antibodies produced will actually disappear with age. Research in relevant medical institutions found that many children are almost still there when they are 5 years old. By the time they are 10 years old, about 20% of them have no antibodies, and about 40% of them have no antibodies at the age of 15. By the time they are 20 years old, even 70% of them have no antibodies.
This is similar to when we go to school. As time goes by, we may forget what we learned, but this part of the memory does not disappear, but exists, and we can remember it just by awakening. Therefore, some people find that they can remember everything after receiving one booster injection without antibodies, but some people completely forget that they must give three doses again to let the immune system realize the production of this antigen.
antibody disappears and can be given a supplement to awaken immune memory
So the absence of hepatitis B antibodies does not mean there is no immune memory, but there is currently no way to measure memory. It is necessary to use a booster vaccine to stimulate it. If the amount of antibodies increases immediately, it means that the immune memory is successfully aroused.
immune memory can exist for at least 10 years, because past studies have found that one injection and immune memory can be aroused at the age of 10. However, if supplemented after ten years, some immune memory may not be aroused. Therefore, if possible, check it when the child is about 10 years old and strengthen the injection according to the situation to avoid the situation where immune memory cannot be awakened.
However, the antibodies disappear and the immune memory cannot be aroused, which means there is no immunity to the hepatitis B virus. When you grow up, you may accidentally get infected with hepatitis B virus and become an asymptomatic carrier of hepatitis B, but this probability is not high.
Speaking of supplementary injections and strengthening injections, the current national policy does not require everyone to make up for the injections, because the tests must be performed after the supplementary injections, which is not ideal from an economic perspective.In addition, after years of immunization injection, my country has reduced the proportion of hepatitis B carriers, the number of cases decreased, and the risk of infection among other people has also decreased. Moreover, hepatitis B is the younger the infection, the more likely it is to become a carrier. Statistics show that 90% of the infection before the age of 1 will become a carrier of chronic hepatitis B; if it is only an infection over the age of 15, there is only a 5-10% chance of becoming a carrier of the virus; if it is an infection for adults, there is only a 2-3% chance of becoming a carrier.
People decide whether to get a supplementary injection depending on the degree of risk
Currently, everyone is encouraged to get a supplementary injection for immunization. For individuals, without hepatitis B antibodies, there is a risk of being infected with the hepatitis B virus. If you don’t want to take risks or have a higher risk of infection, you are a high-risk group and you can choose to get a supplementary vaccine by yourself.
The main infection routes of hepatitis B are blood, body fluids and sexual behaviors, so high-risk groups include: hemodialysis patients, organ transplant patients, people receiving blood preparation treatment, immunity insufficiency, multiple partners, people who often need medication injections, people with hepatitis B virus carriers, and medical and rescue workers who may be exposed to blood.
In addition to the long-term exposure of risks for medical staff who are working factors, they already stipulate that they should get a booster shot, most people can get a supplementary shot (it can last for another 10 years after waking up the immune memory). In addition, it may not be necessary to continue to get a supplementary shot every 10 years. What is the process of re-injection of hepatitis B vaccine?
When the blood test report shows that the surface antibodies of hepatitis B are negative, then look at the core antibodies. If they all react negatively, it means that they are not infected with hepatitis B virus and lack immunity to hepatitis B virus, and need to be vaccinated. However, this situation is divided into two types:
1. People who have not received 3 doses of hepatitis B vaccine in the past : 3 doses of vaccine must be received (interval of 0, 1, 6 months), and surface antibodies can be tested 1 month after the vaccination is completed. Antibodies were detected in
, indicating that the vaccination was successful and immunity to hepatitis B virus.
did not detect antibodies, indicating that it is difficult to produce antibodies due to physical constitution.
2. In the past, there were people who completed hepatitis B vaccination : First give a supplementary injection, and then check whether there are surface antibodies.
has a sufficient amount of antibodies, indicating that the hepatitis B virus still has immune memory and has successfully strengthened the immune memory again and has immunity to the hepatitis B virus.
did not detect antibodies or the amount of antibodies was not high, which means that the immune memory has disappeared. Two more shots are needed, and the surface antibodies are tested 1 month after the vaccination is completed. If there is an antibody, it means that the re-inoculation is successful and immunity is effective. Otherwise, it means that the antibody is difficult to produce due to physical constitution.
In addition, if the core antibody is positive, it means that hepatitis B has been infected with hepatitis B and does not need to be vaccinated, but hepatitis B surface antigen is tested. If the surface antigen is positive, it means hepatitis B infection and the antigen lasts for 6 months, it is a carrier of hepatitis B virus and needs regular follow-up examinations and treatment.
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