Hepatitis B Vaccine Boosters: Key Questions Answered

Questions about booster shots for Hepatitis B vaccine?

Hello, Doctor: My mother is a carrier of hepatitis B.
My two daughters received immunoglobulin within 24 hours of birth.
My younger daughter received her first dose of the hepatitis B vaccine on June 2, 2022, at the hospital.
The doctor advised that we should check her antibody levels one month later, but I waited until six months later, on January 17, 2023, to take her for blood testing.
The report showed that her hepatitis B surface antibody (Anti-HBs) was positive at 163.00 IU/L and her hepatitis B core antibody (Anti-HBc) was negative at 2.33 COI.
I returned to the clinic on July 18, 2023, to discuss the report, and the doctor mentioned that since we did not check the blood one month after the first dose and delayed it by five months, the report is no longer accurate.
We need to administer the first dose of the hepatitis B vaccine again and check her blood again in one month.
If the antibody levels are insufficient, we will then administer the second and third doses.
My question is: Since my 10-year-old daughter received her first dose of the hepatitis B vaccine on June 2, 2022, and the blood test report on January 17, 2023, showed that her hepatitis B surface antibody (Anti-HBs) was positive at 163.00 IU/L and her hepatitis B core antibody (Anti-HBc) was negative at 2.33 COI, does she really need to receive the first dose of the hepatitis B vaccine again? If the blood test in one month shows insufficient levels, will she then receive the second and third doses?

Er Bao Ma, 40~49 year old female. Ask Date: 2023/07/23

Dr. Chen Shidian reply Gastroenterology and Hepatology

The principle is to respect the recommendations of pediatricians.

Reply Date: 2023/07/23

More Info

Understanding the nuances of Hepatitis B vaccination, especially in the context of a child born to a Hepatitis B carrier, is crucial for ensuring effective immunity and health management. In your case, your daughter received her first dose of the Hepatitis B vaccine at a young age, which is a standard practice for infants born to Hepatitis B positive mothers. The administration of immunoglobulin (HBIG) alongside the vaccine is also a critical step in providing immediate passive immunity.

From the blood test results you provided, your daughter has a positive Anti-HBs level of 163.00 IU/L, which indicates that she has developed antibodies against the Hepatitis B virus (HBV) following vaccination. This is a good sign, as it suggests that the vaccine has been effective in eliciting an immune response. The negative Anti-HBc result further supports that there is no current or past infection with HBV, as Anti-HBc typically indicates exposure to the virus.

Regarding the doctor's recommendation to re-administer the first dose of the Hepatitis B vaccine, it is essential to clarify that the timing of antibody testing is critical. Ideally, the antibody levels should be checked about one to two months after the completion of the vaccination series to confirm adequate immune response. Since your daughter had her first dose in June 2022 and the antibody test was conducted in January 2023, the timing may have led to some confusion regarding the interpretation of her immune status.

If the doctor believes that the antibody levels may not be sufficient or that the timing of the test could have affected the results, it is reasonable to follow their advice to re-administer the first dose of the vaccine. The rationale behind this is to ensure that your daughter has adequate protection against Hepatitis B, especially given her mother's carrier status. After re-administering the vaccine, the doctor will likely recommend another blood test one month later to assess the Anti-HBs levels again. If the levels are still insufficient, the subsequent doses (second and third) will be administered as needed.

It is important to note that the Hepatitis B vaccine is highly effective, and most individuals will develop immunity after completing the vaccination series. However, in some cases, particularly in individuals with certain health conditions or immunocompromised states, the response may be suboptimal. Therefore, monitoring and follow-up are essential.

In summary, your daughter's positive Anti-HBs level indicates that she has likely developed immunity to Hepatitis B, but following the doctor's advice to re-administer the vaccine and retest is a prudent approach to ensure her long-term protection. Vaccination is a critical tool in preventing Hepatitis B infection, especially for those at higher risk due to family history or exposure. Always consult with your healthcare provider for personalized medical advice and follow their recommendations for vaccination schedules and follow-up testing.

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