Hepatitis B Antibody Levels and Vaccination Recommendations

Hepatitis B testing

Hello Dr.
Chen: Last October, I had a test regarding hepatitis B, and the results showed that the hepatitis B surface antigen was negative and the hepatitis B surface antibody was 86.6.
Since a classmate just received the hepatitis B vaccine, their antibody level is relatively high (around 1000).
I would like to ask you, at what antibody level do you usually recommend getting a booster vaccine? As I work in dentistry, I am often at risk of being punctured by sharp objects.
Additionally, if I do need a booster, which types of vaccines should I receive? Should I visit a family medicine or gastroenterology clinic? Will this be an out-of-pocket expense? Thank you for taking the time to answer my questions!

Jiun, 20~29 year old female. Ask Date: 2008/10/15

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, for individuals who have received the hepatitis B vaccine, a portion of patients may experience a decline in antibodies to undetectable levels (resulting in a negative test).
In such cases, a booster shot is recommended, which is an out-of-pocket expense.
If antibodies are still present, upon exposure to the hepatitis B virus, the immune memory cells can still produce more antibodies, thus a booster vaccine is not necessary.
Regarding healthcare workers, if they experience a needle stick injury, there is a risk of transmission of hepatitis B, hepatitis C, syphilis, and HIV.
Aside from hepatitis B, there are no other vaccines available for the prevention of these infections.
Best regards, Dr.
Chen Chih-Feng, Taoyuan Hospital, Department of Health.

Reply Date: 2008/10/15

More Info

Understanding Hepatitis B antibody levels and vaccination recommendations is crucial, especially for individuals in high-risk professions such as dentistry, where exposure to bloodborne pathogens is a concern. Based on your inquiry regarding your Hepatitis B test results, let's break down the components and provide a comprehensive understanding.

Your test results indicate that you are negative for Hepatitis B surface antigen (HBsAg) and positive for Hepatitis B surface antibody (anti-HBs) at a level of 86.6. This suggests that you have either been vaccinated against Hepatitis B or have recovered from a past infection, as the presence of anti-HBs indicates immunity. The fact that your anti-HBs level is below 1000, especially in comparison to your classmate's recent vaccination results, raises a valid question about the longevity of your immunity and whether you should consider a booster vaccination.

Typically, the protective level of anti-HBs is considered to be above 10 mIU/mL. Your current level of 86.6 mIU/mL indicates that you are still within the protective range, but it is important to note that antibody levels can decline over time. In general, if your anti-HBs levels drop below 10 mIU/mL, it is recommended to receive a booster dose of the Hepatitis B vaccine. Given your profession and the potential risk of exposure to Hepatitis B, maintaining adequate antibody levels is essential.

Regarding your question about the timing for a booster vaccination, if your anti-HBs levels were to fall below 10 mIU/mL, it would be advisable to receive a booster dose of the Hepatitis B vaccine. The vaccine is typically administered in a series of three doses, but if you are already immune (as indicated by your current anti-HBs level), a single booster dose may suffice to elevate your antibody levels back into the protective range.

As for where to receive the vaccination, both family medicine clinics and gastroenterology/hepatology departments can administer the Hepatitis B vaccine. It is advisable to consult with your healthcare provider to determine the best course of action based on your specific health needs and occupational risks.
In terms of cost, the Hepatitis B vaccine is often covered by insurance, but it can vary based on your plan and whether you are receiving it as part of a routine vaccination schedule or as a booster due to occupational exposure. If it is not covered, the vaccine may be considered a self-pay item, and you should inquire about the costs beforehand.

In summary, your current anti-HBs level of 86.6 mIU/mL indicates that you have protective immunity against Hepatitis B. However, due to your profession and the potential for exposure, it is wise to monitor your antibody levels regularly. If they fall below 10 mIU/mL, a booster vaccination is recommended. Consult with your healthcare provider to discuss your vaccination options and ensure that you remain protected against Hepatitis B.

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