Can You Get Hepatitis B After Vaccination? Risks and Testing

After receiving the hepatitis B vaccine, can one still contract hepatitis B?

Hello Doctor: I received the hepatitis B vaccine when I was in elementary school, and my liver function tests were normal during my vocational school health check.
Two years ago, my blood donation report also showed normal liver function.
However, a few days ago, my health check report indicated that my GOT was 59 and GPT was 77, which are significantly elevated.
I would like to know if I can still contract hepatitis B after being vaccinated, especially since my father and brother are both carriers of hepatitis B.
Should I get tested again? All my previous tests were normal.
Additionally, my white blood cell count is also low; what should I pay more attention to? Thank you.

Xiao Pan, 20~29 year old female. Ask Date: 2004/10/13

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! Elevated liver function does not necessarily indicate that you have hepatitis B.
The letter mentioned that you have received the hepatitis B vaccine, but it is unclear whether you were tested afterward to see if you developed surface antibodies.
If you did, that means you have developed immunity and will not be infected with hepatitis B.
There are many potential causes for elevated liver function, such as medication use, alcohol consumption, or recent weight gain.
Hepatitis C could also be a factor.
To determine the cause, you will need to consult a hepatologist for further evaluation.
How low are your white blood cell counts?

Reply Date: 2004/10/13

More Info

Vaccination against Hepatitis B is a crucial public health measure that has significantly reduced the incidence of this viral infection. The Hepatitis B vaccine is highly effective, and individuals who have been vaccinated typically develop antibodies that provide immunity against the virus. However, concerns about the possibility of contracting Hepatitis B after vaccination, especially in individuals with a family history of the disease, are valid and deserve careful consideration.

Firstly, it is important to understand how the Hepatitis B vaccine works. The vaccine stimulates the immune system to produce antibodies against the Hepatitis B virus (HBV). A positive test for Hepatitis B surface antibodies (Anti-HBs) indicates that a person has developed immunity, either through vaccination or previous infection. In your case, since you were vaccinated in childhood, it is likely that you have developed these protective antibodies. However, antibody levels can decline over time, and it is possible, although rare, for vaccinated individuals to become susceptible to infection if their antibody levels fall below protective thresholds.

Given your family history of Hepatitis B, it is prudent to monitor your health closely. The fact that your father and brother are carriers of the virus increases your risk of exposure, particularly if you have had any potential contact with their blood or bodily fluids. However, the presence of Anti-HBs in your system indicates that you have a level of immunity against the virus, which significantly reduces your risk of infection.

Regarding your recent blood test results showing elevated liver enzymes (GOT and GPT), it is essential to investigate further. Elevated liver enzymes can indicate liver inflammation or damage, which may be due to various causes, including viral hepatitis, alcohol consumption, medication effects, or other liver diseases. Since you have a family history of Hepatitis B, it would be wise to undergo further testing to rule out any active infection. This may include testing for Hepatitis B surface antigen (HBsAg) and Hepatitis B core antibody (Anti-HBc) to determine if there is any current infection or past exposure.

As for your low white blood cell count, this condition, known as leukopenia, can have various causes, including viral infections, bone marrow disorders, or the effects of certain medications. It is crucial to consult with your healthcare provider to determine the underlying cause and appropriate management strategies. Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding substances that can harm the liver (such as alcohol and certain medications), can help support your immune system and overall health.

In summary, while vaccination against Hepatitis B provides significant protection, it is essential to remain vigilant, especially with a family history of the virus. Regular check-ups and blood tests can help monitor your liver health and ensure that any potential issues are addressed promptly. If you have concerns about your vaccination status or the need for booster shots, discussing this with your healthcare provider can provide clarity and guidance tailored to your specific situation.

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