Which type of hepatitis B vaccine should children receive?

Apr 10, 2023 Source: Cainiu Health

Dr. Jiang Weimin

Introduction

Children can generally receive either recombinant hepatitis B vaccine or freeze-dried hepatitis B vaccine. According to the recommendations of the Chinese Center for Disease Control and Prevention, children should receive the first dose of hepatitis B vaccine within 24 hours after birth, with subsequent doses administered at 1-month and 6-month intervals. When vaccinating against hepatitis B, either recombinant or freeze-dried hepatitis B vaccine may be selected based on actual circumstances.

Children can generally receive either recombinant hepatitis B vaccine or lyophilized (freeze-dried) hepatitis B vaccine.

The recombinant hepatitis B vaccine is produced using genetic recombination technology and contains the hepatitis B surface antigen as its main component, effectively preventing hepatitis B virus infection. This type of vaccine is typically liquid and must be shaken well before administration.

The lyophilized hepatitis B vaccine is made by freeze-drying the recombinant vaccine, allowing it to be stored at room temperature, which facilitates transportation and storage. Before injection, the lyophilized vaccine must be reconstituted with an appropriate amount of normal saline or another diluent.

According to recommendations from the Chinese Center for Disease Control and Prevention, children should receive their first dose of hepatitis B vaccine within 24 hours after birth, followed by additional doses at 1 month and 6 months of age. Either recombinant or lyophilized hepatitis B vaccine may be selected based on actual circumstances.

If there are any questions, it is recommended to consult a physician or vaccination provider. After receiving the hepatitis B vaccine, children should avoid eating spicy or irritating foods to prevent interference with vaccine efficacy.

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In addition, adverse reactions such as fever, fatigue, and local redness and swelling may occur after vaccination. If the interval between vaccines is too short, it becomes difficult to determine which vaccine caused the reaction, hindering timely assessment and management. In urgent situations, such as potential exposure to hepatitis B, professional evaluation should be conducted to weigh the risks and decide whether early vaccination is warranted. For non-urgent cases, the recommended intervals must be strictly followed.

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What should I do if my baby keeps sleeping after receiving the second hepatitis B vaccine shot?

It is usually a normal reaction after vaccination if a baby sleeps continuously following the second hepatitis B vaccine dose. This can be managed by monitoring sleep duration, observing mental status, checking the injection site, ensuring adequate hydration, and adjusting caregiving practices. In most cases, symptoms will resolve on their own. However, if the baby sleeps for more than 24 hours and is difficult to wake, or if there are accompanying symptoms such as fever, vomiting, or lethargy, prompt medical attention is recommended.

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What should be done if a child does not develop antibodies after multiple doses of the hepatitis B vaccine?

For children who fail to develop antibodies after multiple doses of hepatitis B vaccine, interventions may include increasing the vaccine dose, switching vaccine types, following standardized catch-up vaccination protocols, screening for occult infection, and evaluating immune function. Scientific, individualized management is required. If symptoms such as fatigue, jaundice, or a family history of hepatitis B are present, prompt medical evaluation and comprehensive testing are recommended.

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How long can the third dose of the hepatitis B vaccine be delayed? Will delaying it by half a month increase the risk of infection?

If the first two doses were administered according to the recommended schedule and the body has already developed a certain level of baseline antibodies, a delay of half a month for the third dose will not lead to hepatitis B virus infection, as the existing baseline antibodies can still provide protection. However, the delay might postpone the time to reach peak antibody levels, and it is necessary to confirm through testing after completing the missed dose whether the antibody levels have reached the required threshold.

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How long should the intervals be for the three booster doses of the hepatitis B vaccine?

In general, the three-dose hepatitis B vaccine booster schedule should follow the 0-1-6 principle: the day of the first dose is considered time point 0; the second dose should be administered one month after the first dose; and the third dose should be given six months after the first. The schedule may be adjusted based on an individual's antibody levels. All doses must be completed on time, and delays should be avoided. After each vaccination, keep the injection site clean.

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Can a health certificate be issued if the hepatitis B surface antibody test is positive?

Hepatitis B surface antibody is a protective antibody. A positive result usually indicates one of two situations: first, the person has previously received the hepatitis B vaccine, prompting the immune system to produce antibodies; second, the person had a past infection with the hepatitis B virus but has since recovered, developing immunological memory. Both situations indicate the absence of current hepatitis B virus infection and demonstrate resistance to the virus, fulfilling the basic requirements for obtaining a health certificate.

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Is it acceptable to administer the second dose of the hepatitis B vaccine one day earlier?

In general, whether the second dose of the hepatitis B vaccine can be administered one day earlier should be determined based on the recipient's health status and vaccine administration guidelines. If in doubt, it is recommended to consult a healthcare professional. After vaccination, keep the injection site clean and dry to prevent infection from water exposure. Avoid strenuous exercise in the short term and maintain a light diet, minimizing intake of spicy and irritating foods.

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What should I do if a hard lump and itching occur after receiving the hepatitis B vaccine?

After receiving the hepatitis B vaccine, if a hard lump and itching occur, symptoms can be relieved by avoiding scratching or irritation, gently cleaning the area, applying warm compresses to promote absorption, wearing loose clothing, and monitoring symptom changes. This is a common local immune response following vaccination. However, if the lump continues to enlarge, itching becomes severe, or is accompanied by pus or fever, prompt medical attention is recommended.

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