What kinds of hepatitis B vaccines are currently used, and their advantages and disadvantages?

At present, there are mainly the following hepatitis B vaccines used in clinic.

(1) Blood-borne hepatitis B vaccine: This vaccine is made from the blood of asymptomatic HBsAg carriers, so it is called blood-borne hepatitis B vaccine. Its preparation steps are roughly as follows: using the blood of HBsAg positive carriers with high titer, separating plasma, removing infected HBV particles, then concentrating and purifying HBsAg, fully inactivating it, eliminating all known viruses that may exist in it and all host proteins that may exist on the surface of HBsAg, and then adding adjuvants and preservatives. In order to ensure the safety of the vaccine, samples should be taken for sterility test, heat source test and animal safety test at each stage to check whether there are other pathogens in the vaccine and whether there are antigenic substances in the blood. The immunogenicity and safety of the vaccine have been solved, but there are still some shortcomings: ① In order to prevent some possible pathogens from escaping inactivation in the preparation process, strict, complicated and time-consuming physical and chemical methods were adopted to purify and inactivate HBsAg antigen, which increased the preparation cost and the vaccine yield was not high. ② With the long-term extensive use of hepatitis B vaccine, the number of asymptomatic HBsAg carriers is bound to decrease gradually, and it will be difficult to prepare vaccines with their blood.

(2) Genetic engineering vaccine: A recombinant DNA hepatitis B vaccine was developed through genetic engineering. Recombinant hepatitis B vaccines of Escherichia coli system, beer yeast cell system, mammalian cell system and vaccinia virus system have been developed successively. At present, the yeast gene recombination vaccines is widely used.

It has good immunogenicity, the immune response characteristics are basically similar to those of blood-borne hepatitis B vaccine, and there is no serious adverse reaction. Although it contains no more than 1% yeast protein, the fear of allergic reaction has not been completely ruled out.

(3) Hepatitis B vaccine containing pre-S protein: At present, the blood-borne vaccine and genetic engineering vaccine used in clinic only contain HBsAg protein. When it is confirmed that S protein can enhance the immune response of HBsAg, and it is noted that the vaccine containing only HBsAg protein has poor immune effect on hemodialysis patients and newborns, the yeast-derived recombinant hepatitis B vaccine with pre-S protein is produced, which can obviously enhance the immune response.