A large percentage of the population is still unaware of the dangers of the hepatitis B virus, and some have missed the best time to treat it. If we find out that we do not have protective antibodies against hepatitis B (hepatitis B surface antibodies), what should we do next? The good thing is that most people are aware of this and we can get the hepatitis B vaccine. Since the 1990s, when the hepatitis B vaccine was widely administered to newborns, the rate of hepatitis B surface antigen carriage in children in China has dropped dramatically, but there are still 5-10% of the population who do not respond to the hepatitis B vaccine, and most of the new cases of chronic hepatitis B virus infection in children are now due to failure of mother-to-child blockade. Nowadays, the most talked about pregnancy for hepatitis B surface-positive mothers is mother-to-child blockade, and the success rate of mother-to-child blockade of hepatitis B virus in China is over 95%, but why do some people still fail to block? The main reason is the lack of timely antiviral treatment during pregnancy or before pregnancy. The current guidelines state that for HBV-DNA greater than 2×105IU/ml in the second trimester 28 weeks can choose tenofovir for antiviral treatment, if during antiviral treatment is found to have been pregnant, if the tenofovir is taken, you can continue the pregnancy. Timely administration of hepatitis B immunoglobulin and hepatitis B vaccine to the newborn after delivery is basically 100% successful in interrupting the transmission of the hepatitis B virus. The quantification of the five hepatitis B tests is repeated at the age of July or August to see if protective antibodies have been produced. A quantitative hepatitis B quantification test after a newborn has received hepatitis B immunoglobulin and hepatitis B vaccine does not truly reflect the child’s immune status against the hepatitis B virus. What about the safety of different types of vaccines? The benefits to both mother and fetus must outweigh the risks for immunization during pregnancy. There is no evidence that inactivated vaccines can harm pregnant women and fetuses. Safe live vaccines may be harmful to the developing fetus, so live vaccines should be avoided to the greatest extent possible during pregnancy. Toxoid, inactivated vaccines, immunoglobulin preparations, and live viral and bacterial vaccines can enhance the immune status of the body. There is no evidence that they are harmful to the pregnancy or the fetus. If a pregnant woman is accidentally vaccinated with a live virus vaccine or conceives within 4 weeks of vaccination, she should be informed of the potential effects of the vaccine on the fetus. Given that there is no proven harm, there is no need to terminate the pregnancy for this indication. Many users ask whether routine hepatitis B vaccination is safe. The hepatitis B vaccination is very safe. After the hepatitis B vaccination, as with most other vaccinations, symptoms such as low fever and muscle aches may occur, but they usually resolve naturally without special treatment. Is it safe for pregnant women to receive the hepatitis B vaccine during pregnancy? At present, our hepatitis B vaccine is a yeast recombinant vaccine (without adjuvant), which uses genetic engineering to express hepatitis B surface antigen based on the S gene sequence in the hepatitis B virus genome, but it does not contain the antigen of the former S region, and is only antigenic and not infectious, thus stimulating our body to produce hepatitis B surface antibodies. Hepatitis B recombinant vaccine without adjuvant is safe for pregnant women as long as it is administered, whether early or late in pregnancy. If our spouse is infected with the hepatitis B virus, it is possible to administer the hepatitis B vaccine during pregnancy if no protective hepatitis B antibodies are found in the pregnant woman. Hepatitis B vaccines are generally divided into single antigen vaccines and combination vaccines. Combination vaccines, as the name implies, are mainly a combination of other vaccines, such as the combination hepatitis A vaccine, and these polyvalent vaccines have similar immunogenicity to monovalent vaccines. Combination vaccines reduce the number of vaccinations and thus improve adherence. Single-antigen vaccines are mainly divided into vaccines without adjuvants and vaccines with adjuvants. The most predominant on the market today are adjuvant-free recombinant vaccines. There are three main types of adjuvant-free single-antigen recombinant vaccines, derived from plasma, yeast and mammalian cells, with yeast-derived recombinant hepatitis B vaccines (without adjuvant) being the most commonly used. Which groups of people need hepatitis B vaccination? 1.As long as people who are surface negative for hepatitis B and negative for hepatitis B surface antibody, in principle, they should be injected with hepatitis B recombinant vaccine, and the adult dose is 20 mcg/dose, respectively, in 0/1/6 months, for a total of three injections. 2. Newborns born to hepatitis B surface antigen-positive mothers. In addition to one dose of hepatitis B immunoglobulin within 12 hours of birth, a total of three doses of hepatitis B recombinant vaccine will be administered. In case of low weight infants, an additional injection of hepatitis B recombinant vaccine (0/1/6/7) is required for a total of four doses each. 3. All newborns. For newborns born to hepatitis B surface antigen-negative mothers, only three doses of hepatitis B recombinant vaccine are needed, and no hepatitis B immunoglobulin is required. If the vaccination fails and no hepatitis B surface antibodies (protective antibodies) are produced, a catch-up hepatitis B vaccination is required. 4. Catch-up vaccination refers to the vaccination of children born before the implementation of the universal newborn vaccination policy. All unvaccinated children and adolescents under the age of 19 should receive the hepatitis B vaccine. Because most such children are of school age, catch-up vaccination allows them to develop immunity before reaching puberty, thereby reducing the risk of contracting HBV through sexual exposure and injection drug use during adolescence. 5. Other high-risk groups include sexually promiscuous people, homosexuals and people co-infected with hepatitis C virus and HIV. So what vaccinations should be avoided during pregnancy? It is very clear that HPV vaccine, combined measles, mumps and rubella vaccine, varicella vaccine, BCG tuberculosis vaccine, live attenuated influenza vaccine and herpes zoster vaccine should be avoided during pregnancy. The need for prenatal vaccinations such as tetanus and tetanus vaccines needs to be determined based on the pregnant woman’s previous immunization status and actual risk needs. In case of exposure to certain pathogens, the relevant vaccine can be selected according to the actual situation according to the exposure process of the corresponding pathogens. For some follow-up questions that are not clearly stated, you can leave me a message.