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Check your hepatitis B antibodies, and get vaccinated if you have none

  • High value
  • Evidence A
  • Buys life
  • Costs a little
  • Takes minutes
  • No willpower

In plain words

The test costs a few dozen CNY. In the Qidong trial, followed for 30 years, people vaccinated against hepatitis B at birth were 84% less likely to get primary liver cancer later and 72% less likely to carry the virus. Adults who test with no antibodies get 3 shots, finished within half a year, for 100 or 200 CNY.

Cost

The test costs a few dozen CNY. The 3-dose adult hepatitis B vaccine totals 100 to 300 CNY. Finish all doses within half a year.

What you get

The Qidong trial was randomized by community, not by individual, and followed people for 30 years. Vaccinating newborns against hepatitis B lowered primary liver cancer by 84% (95% CI 23% to 97%, the plausible range). The rate of hepatitis B surface antigen (HBsAg) positivity fell 72% (95% CI 68% to 75%); this rate is the share of people found to be carrying the virus. The HBsAg-positive share of China's whole population fell 52% from 1992 to 2014, and 97% among children under 5.

Notes

This applies to adults born before 1992 who were never vaccinated or whose antibodies have disappeared. The 84% drop in liver cancer comes from people vaccinated at birth. In the same trial, for those vaccinated only as teenagers, the effect in preventing virus carriage was only 21%. For adults, vaccination is mainly about not getting infected, and that 84% can't be applied directly. Vaccination does nothing for someone already infected, who should see a liver clinic for regular checks. How to tell whether you are infected: the hepatitis B surface antigen (HBsAg) line on your lab report is positive.

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Qu C 等 (2014). Efficacy of neonatal HBV vaccination on liver cancer and other liver diseases over 30-year follow-up of the Qidong hepatitis B intervention study. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1001774
  2. Cui F 等 (2017). Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China. Emerging Infectious Diseases. https://doi.org/10.3201/eid2305.161477

Mentioned in

Translated from the Chinese original. Original book, section 1, tip 14. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer