Hepatitis B Vaccination and Antibody Testing for Students - Internal Medicine

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Hepatitis B vaccination administration


Hello, Dr.
Hsiao! The child was born in 1988 and received four doses of the hepatitis vaccine according to government policy at that time.
This year, due to enrollment in a dental program abroad, a hepatitis B antibody test was conducted, which resulted in a negative response (a positive response is required for enrollment).
Therefore, 1> The child is currently starting to receive the hepatitis B vaccine again.
(Is this necessary?) 2> After completing three doses, will there be a positive response? 3> If there is no positive response after completing three doses, does this mean that the child will not be able to achieve a positive response in the future? (Or could there be an error in the test?) 4> If the response is negative, does this mean that the child has no antibodies and is at a higher risk for hepatitis B infection? Thank you for taking the time to explain!

Chen, 40~49 year old female. Ask Date: 2006/03/20

Dr. Xiao Jingqin reply Internal Medicine


1.
It is possible to receive the hepatitis B vaccine again.

2.
Not necessarily; the hepatitis B vaccine can produce antibodies in over 95% of recipients, but it is not 100%.

3.
After completing the three-dose series, antibody testing should be conducted 3 to 6 months later.
If there are concerns about testing accuracy, a nuclear medicine test can be considered, as it has a higher accuracy rate (most medical facilities use enzyme immunoassays for testing).
If the nuclear medicine test still shows negative for antibodies, it is possible that the individual may not produce antibodies at all, although in rare cases, the antibody levels may be too low to detect.

4.
The transmission route of hepatitis B is through body fluids, with a transmission rate of approximately 30% through needle-stick injuries, which is considered high.
Healthcare workers should be particularly cautious to prevent infection; however, not having hepatitis B antibodies does not preclude one from working in healthcare.

Reply Date: 2006/03/20

More Info


Hello! Thank you for your questions regarding Hepatitis B vaccination and antibody testing for your child. Let's break down your concerns one by one.

1. Is it necessary to restart the Hepatitis B vaccination?
Given that your child was vaccinated according to the government policy and has now tested negative for Hepatitis B antibodies, it is indeed advisable to restart the vaccination series. The standard vaccination schedule typically consists of three doses of the Hepatitis B vaccine, which are administered at 0, 1, and 6 months. If your child has not developed antibodies after the initial vaccination series, it may be necessary to receive a booster or a complete re-vaccination series to ensure adequate immunity.

2. Will completing the three doses guarantee a positive antibody response?
While the majority of individuals will develop protective antibodies after completing the three-dose series, it is not guaranteed. Studies show that about 90-95% of healthy individuals will develop antibodies following vaccination. Factors such as age, underlying health conditions, and the immune response can influence the effectiveness of the vaccine. Therefore, while it is likely that your child will develop a positive response, it is not an absolute certainty.

3. If there is no positive response after the three doses, does it mean there will never be a positive response?
If your child does not develop antibodies after completing the three doses, it does not necessarily mean that they will never respond to the vaccine. Some individuals may require additional doses or a different vaccination strategy. It's also possible that there could be an error in the testing process, so it may be worthwhile to repeat the antibody test after the vaccination series is completed. Consulting with a healthcare provider who specializes in infectious diseases or immunology can provide further insights and recommendations.

4. If the test remains negative, does it mean your child is at a higher risk for Hepatitis B infection?
Yes, if the antibody test remains negative after vaccination, it indicates that your child does not have protective antibodies against Hepatitis B. This lack of immunity means that your child could be at a higher risk for contracting Hepatitis B if exposed to the virus. Hepatitis B is transmitted through contact with infectious body fluids, including blood, semen, and vaginal secretions. Therefore, it is crucial to ensure that your child develops immunity through vaccination to reduce the risk of infection.

In summary, it is important to follow through with the vaccination series and monitor your child's antibody response. If there are any concerns or if your child continues to test negative for antibodies after the vaccination series, further evaluation by a healthcare professional is recommended. They may suggest additional testing or alternative vaccination strategies to ensure your child's health and safety, especially considering their studies abroad in a dental program where Hepatitis B vaccination may be a requirement.

Thank you for your inquiry, and I hope this information helps clarify your concerns regarding Hepatitis B vaccination and antibody testing!

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