Hepatitis B Vaccination: Antibody Absence and Next Steps

Hepatitis B vaccine issues?

Hello Dr.
Hsu, I would like to ask you about the issue of hepatitis B vaccination.
Recently, after a company health check, it was found that the results showed no hepatitis B surface antibodies (I also went to the Veterans General Hospital for a check-up, and the result was the same with no antibodies).
Therefore, the health check hospital recommended "vaccination." However, I have a few questions:
1.
Why is it that the current test results show no antibodies?
2.
Is it necessary to arrange for vaccination at a hospital?
3.
If vaccination is needed, where should it be administered? Which department should I visit?
Thank you.

Awei, 30~39 year old female. Ask Date: 2008/08/19

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello!
1.
This situation is quite common and can occur in two scenarios.
The first is that most people do not get tested for antibody production after receiving vaccinations in childhood, so it is possible that despite being vaccinated, due to individual variations in physiology, some people may not produce antibodies.
This group accounts for about 10-15% of the population.
The second scenario is that individuals who have been vaccinated may initially produce antibodies, but as they age, the concentration of antibodies in their bodies gradually decreases, potentially to levels that are undetectable by testing.
Your situation cannot confirm which of these scenarios applies, so it is recommended that since antibodies are currently undetectable, you should receive a booster dose of the vaccine to see if antibody levels increase.
2.
You can visit a clinic or hospital that is convenient for you.
You can see a family medicine or hepatology specialist; however, please note that adult vaccinations are typically self-paid.
Thank you for your inquiry.
If there are any further questions, feel free to reach out again.
Additionally, the foundation has a liver disease consultation hotline at 0800-000583, available for phone consultations from Monday to Friday, 8:30 AM to 9:00 PM, and Saturday from 8:30 AM to 12:00 PM, where professionals and volunteers provide online consultation services.
We also have free publications available for your reference.
Wishing you good health.
Sincerely,
The Foundation for Liver Disease Prevention and Treatment Academic Foundation
Date: 97/08/20

Reply Date: 2008/08/19

More Info

Hello! Thank you for your questions regarding Hepatitis B vaccination and the absence of antibodies. Let's break down your concerns systematically.

1. Why are there no antibodies present despite previous vaccinations?
The absence of Hepatitis B surface antibodies (Anti-HBs) in your blood test results, despite having received the vaccine series in childhood, can be attributed to several factors. First, not everyone who receives the Hepatitis B vaccine develops a sufficient immune response. Studies suggest that about 5-10% of vaccinated individuals may not produce detectable levels of antibodies. This can be due to individual variations in immune response, age at vaccination, or underlying health conditions that may affect immune function. Additionally, the immunity provided by the vaccine can diminish over time, especially if the initial response was weak.

2. Should you arrange to receive the vaccine again?
Yes, it is advisable to receive the Hepatitis B vaccine again. The Centers for Disease Control and Prevention (CDC) recommends that individuals who do not have detectable antibodies after vaccination should complete a second series of the vaccine. This typically consists of three doses administered over six months. After completing the series, a follow-up blood test can be done to check for the presence of antibodies. If the antibodies are still absent after the second series, further evaluation may be necessary to understand the underlying reasons.

3. Where should you go for vaccination? What department should you visit?
You can receive the Hepatitis B vaccine at various healthcare facilities, including your primary care physician's office, community health clinics, or specialized infectious disease clinics. It is advisable to visit a clinic that offers vaccinations or a family medicine department. When you arrive, you can inform the staff that you need the Hepatitis B vaccine due to the absence of antibodies in your recent tests.

Additional Information on Hepatitis B Vaccination
Hepatitis B is a viral infection that affects the liver and can lead to chronic disease, liver cirrhosis, or liver cancer. Vaccination is the most effective way to prevent Hepatitis B infection. The vaccine is safe and effective, providing long-lasting immunity in most individuals.

The vaccine is typically administered in three doses:
- The first dose is given at a chosen time.

- The second dose is given one month after the first.

- The third dose is administered six months after the first dose.

If you are concerned about your immune response or have specific health conditions, it may be beneficial to discuss this with your healthcare provider. They can provide personalized advice and may recommend additional tests to assess your immune function.

In summary, the absence of Hepatitis B surface antibodies after vaccination is not uncommon and can be addressed by receiving a booster series of the vaccine. Make sure to follow up with your healthcare provider for the best course of action. Stay proactive about your health, and don’t hesitate to reach out for further clarification or assistance.

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