I. Immunization procedures, contraindications and precautions (a) Hepatitis B vaccine immunization procedures? A total of three doses of hepatitis B vaccine are required for the whole immunization process, and the immunization procedures are 0, 1 and 6 months, i.e. the first dose of hepatitis B vaccine is given within 24 hours after birth, and the second and third doses of hepatitis B vaccine are given at 1 month and 6 months. Timely and complete administration of the first dose of hepatitis B vaccine is the key to ensuring the protective effect of hepatitis B vaccine. The first dose of hepatitis B vaccine should be given within 24 hours after birth, and the earlier the better. (2) What are the contraindications to hepatitis B vaccination? Contraindications to hepatitis B vaccination include: known allergy to any component of the vaccine, including excipients, formaldehyde, and antibiotics; acute illness, severe chronic illness, acute exacerbation of chronic illness, and fever; women during pregnancy; and those with uncontrolled epilepsy and other progressive neurological disorders. (iii) Can the hepatitis B vaccine be used together with other vaccines? Hepatitis B vaccine can be administered at the same time as influenza vaccine, BCG vaccine, Bacille Calmette-Guérin (BCG) vaccine, polio vaccine, cerebral B vaccine, vaccine containing measles, hepatitis A vaccine, etc. Hepatitis B vaccine and other vaccines should be administered separately at different sites. Immunization effect of hepatitis B vaccine (a) The protection time of hepatitis B vaccine? The level of antibody produced after hepatitis B vaccination decreases gradually with time. The higher the antibody titer, the longer it lasts. Generally, 97% of people can detect hepatitis B surface antibodies (anti-HBs) 1-3 months after 3 doses of vaccination; the same level is maintained at 1 year, and the positive rate decreases gradually afterwards, to about 74% at the third year after vaccination, and the antibody titer also decreases gradually. A large amount of information shows that the protective effect of antibody responders after hepatitis B vaccination can last at least 20 years. (2) When can antibody be detected in newborns after receiving three doses of hepatitis B vaccine? After a newborn has received 3 doses of hepatitis B vaccine, antibody testing (anti-HBs) may not be performed in the general population. If the mother is HBsAg positive, it is necessary for the newborn to be tested for antibodies. Blood can be collected 1 to 5 months after the completion of the full course of hepatitis B vaccination, as this is when the antibody titer is highest, and if anti-HBs is < 10 mIU/ml, revaccination can be performed. (c) What are the problems and effectiveness of the 3 doses of hepatitis B vaccine given by different companies or types of vaccines during the basic immunization? In theory, the effect of using different companies or different types of hepatitis B vaccine and different doses of vaccine in succession is not affected. However, to ensure operational standardization, the same brand and the same dose of hepatitis B vaccine should be used. (D) Do I need a booster after vaccination? Anti-HBs monitoring or booster vaccination is not required for the general population as the protection effect is better for those who have antibody response after hepatitis B vaccination. The World Health Organization also has no recommendation for booster vaccination for hepatitis B vaccine. 3. Do the different combinations of common positive hepatitis B half tests require vaccination? (a) Can two positive anti-HBs and anti-HBc be vaccinated against hepatitis B? A positive anti-HBs and anti-HBc indicates previous infection with hepatitis B virus (HBV), and protective antibodies (anti-HBs) have been produced, so there is no need for hepatitis B vaccination. (2) Are anti-HBs, anti-HBe, and anti-HBc positive people still having virus replication? Can they receive hepatitis B vaccine? If the above three antibodies are positive, it means that after infection with hepatitis B virus (HBV), HBV has stopped replicating and there is immunity to HBV, so there is no need to receive hepatitis B vaccine. However, for some patients with recurrent chronic hepatitis, although they present three positive anti-HBs, anti-HBe and anti-HBc, there is still a possibility of hepatitis B virus replication by mutant strains. (C) Is it necessary for hepatitis B patients to receive hepatitis B vaccine? Hepatitis B patients and hepatitis B surface antigen carriers do not have any effect on hepatitis B vaccine, so they do not need to receive hepatitis B vaccine; for those who have been infected with hepatitis B virus in the past and have naturally obtained effective protective antibodies (positive hepatitis B surface antibodies in the hepatitis B "two-and-a-half" test), there is no need to receive the vaccine again. However, even if hepatitis B vaccine is given to these infected persons, it will not cause adverse reactions. (d) I am a mother-to-be who is 7 months pregnant, and both my husband and I are carriers of hepatitis B. What should I do to prevent the transmission of hepatitis B after the birth of my child? In order to maximize the protection of the newborn, the child should be vaccinated with hepatitis B vaccine and 100 IU of hepatitis B immunoglobulin as soon as possible within 24 hours after birth, and complete the full course of hepatitis B vaccination in January and June. 4. How to vaccinate hepatitis B in key groups of adults and in case of accidental exposure? (1) What are the priority groups for hepatitis B vaccination? Certain key populations of adults have high exposure and are at high risk of hepatitis B virus infection, so hepatitis B vaccination is recommended. Priority groups recommended by the World Health Organization and the CDC for hepatitis B vaccination include people who require frequent use of blood or blood products, hemodialysis patients, solid organ transplant recipients, prison inmates, people with chronic liver disease, intravenous drug users, people with HIV infection, family members and sexual contacts of people with chronic HBV infection, people with multiple sexual partners, people attending STD clinics, diabetic patients, medical professionals, and others who may be at risk for hepatitis B infection due to their occupations. Medical workers and others who may be exposed to blood and blood products for occupational reasons. (2) How to get vaccinated against hepatitis B in case of accidental exposure (e.g., wound contaminated with blood containing hepatitis B virus or skin pricked by needle contaminated with hepatitis B virus)? Different treatment measures should be taken according to different situations: 1. For exposed persons who have not received hepatitis B vaccine: first inject 200~400 IU of hepatitis B immunoglobulin (within 12 hours), the earlier the better, and at the same time receive the first dose of hepatitis B vaccine at different sites, and receive the second and third doses of hepatitis B vaccine after an interval of 1 and 6 months. If you have been tested for hepatitis B infection indicators in the past and appear positive for hepatitis B surface antigen, you may not need to be vaccinated. 2.If the exposed person has been vaccinated with hepatitis B vaccine in the past but has not completed the full immunization, he should be injected with hepatitis B immunoglobulin and complete the three full immunization doses according to the hepatitis B vaccine immunization procedure. 3.Exposed persons who have received hepatitis B vaccine and have developed hepatitis B surface antibody should be according to their antibody levels. If the level of hepatitis B surface antibody is ≥100 mIU/ml, there is no need to deal with it; for those who are <100 mIU/ml, a booster injection should be given; if there is no response to the initial immunization, hepatitis B immunoglobulin should be injected as soon as possible at a dose of 200~400 IU, and the first dose of hepatitis B vaccine should be given at different sites, and the second and third doses of hepatitis B vaccine should be given after an interval of 1 and 6 months. V. Use of hepatitis B immunoglobulin Hepatitis B immunoglobulin is isolated from healthy blood donors, whose plasma contains high titers of anti-HBs and is made through a concentration process, which has a good immune effect on hepatitis B virus. It is generally used in two cases: 1. To block mother-to-child transmission, newborns born to HBsAg-positive mothers should be given an injection of 100 IU to 200 IU of immunoglobulin within 24 hours after birth, and three doses of hepatitis B vaccine should be completed according to the immunization program, which has a good effect on blocking mother-to-child transmission of hepatitis B virus. 2. If a doctor or nurse, etc., when treating, caring for or collecting blood from a hepatitis B patient, accidentally gets his finger pierced by blood infected with hepatitis B virus, inhales or splashes into wounds or mucous membranes, these hepatitis B exposed persons should be given an injection of hepatitis B immunoglobulin 200 IU immediately, with a second injection after an interval of 1 month, and 3 injections of hepatitis B vaccine at the same time, which can play a preventive effect against infection.