Hepatitis B Vaccine Concerns in Children: A Parent's Guide

Hepatitis B vaccine injection issues?

Hello Doctor: My child (high school) has a weak positive result for hepatitis B antibodies (approximately 17) and received a booster dose of the hepatitis B vaccine.
I would like to ask the following questions:
1.
Is a weak positive result still considered positive, and does it provide any protection?
2.
If the booster vaccine was accidentally administered at double the dose (GSK brand, 1ml per dose, so 2ml was given), could this cause harm to the body? It has been about 8 days since the injection, and my child has not experienced any adverse reactions.
3.
The hepatitis B vaccine is an inactivated recombinant vaccine and does not cause infection; is this understanding correct?
4.
The school health check unit recommends administering 3 doses, but if the double dose was indeed given this time, is it necessary to administer the remaining 2 doses? Could receiving too many vaccines be harmful?
5.
I have seen reports that the dose of the hepatitis B vaccine given to newborns is also 1ml; is this the same dosage as for adults?
Sincerely, a worried mother.

Sally, 40~49 year old female. Ask Date: 2012/05/21

Dr. Xiao Kaiwen reply Pediatrics

1.
A weak positive result may indicate insufficient protection, so it is still recommended to receive an additional hepatitis B vaccine.
2.
It should not cause any harm to the body.
3.
The hepatitis B vaccine does not cause hepatitis B infection.
4.
Infants born after 1986 have been comprehensively vaccinated with the hepatitis B vaccine by the government, so your child should have already received three doses of the hepatitis B vaccine during infancy.
Currently, an additional dose of the hepatitis B vaccine can be administered, and then antibody testing can be performed.
If antibodies are present, no further vaccination is needed; if not, the remaining two doses can be completed (regardless of whether the first dose was a double dose) before retesting for antibodies.
5.
The dosage of the hepatitis B vaccine given to newborns is the same as that given to adults.

Reply Date: 2012/05/21

More Info

Dear Concerned Parent,
Thank you for your questions regarding Hepatitis B vaccination and the concerns surrounding your child's health. It's understandable to have questions, especially when it comes to vaccinations and potential exposure to viruses like Hepatitis B. Let’s address your concerns one by one.

1. Weak Positive Antibody Levels: A weak positive result for Hepatitis B surface antibodies (anti-HBs) indicates that your child has some level of immunity against the virus, but it may not be sufficient for full protection. Generally, a level above 10 mIU/mL is considered protective. Since your child's level is around 17, it suggests that there is some immunity, but it may be advisable to discuss with your healthcare provider whether a booster shot is necessary to ensure adequate protection.

2. Double Dose of Vaccine: If your child accidentally received double the dose of the Hepatitis B vaccine, it is generally not harmful. The Hepatitis B vaccine is well-tolerated, and while receiving an extra dose may not be necessary, it typically does not cause adverse effects. Since your child has not shown any negative reactions after eight days, it is likely that they are fine. However, it’s always a good idea to inform your healthcare provider about the incident for their records and advice.

3. Nature of the Hepatitis B Vaccine: You are correct that the Hepatitis B vaccine is a non-infectious, recombinant DNA vaccine. This means it does not contain live virus and cannot cause Hepatitis B infection. The vaccine works by stimulating the immune system to produce antibodies against the virus, providing protection without the risk of disease.

4. Additional Doses After Double Vaccination: If your child has already received a double dose, it is essential to consult with your healthcare provider regarding the need for additional doses. Generally, if a child has received an adequate number of doses and has developed sufficient immunity, additional doses may not be necessary. However, your healthcare provider can assess the situation based on your child's antibody levels and vaccination history.

5. Vaccine Dosage for Infants and Adults: The standard dose of the Hepatitis B vaccine is indeed 1 mL for both infants and adults. This dosage is effective for inducing an immune response in individuals of all ages. The vaccine is formulated to be safe and effective regardless of the recipient's age, which is why the same dosage is used across different age groups.

In conclusion, it is crucial to maintain open communication with your healthcare provider regarding your child's vaccination status and any concerns you may have. Regular monitoring of antibody levels and adherence to vaccination schedules are essential for ensuring long-term protection against Hepatitis B. If you have any further questions or if your child's health changes, do not hesitate to reach out to a medical professional for guidance.

Wishing you and your family good health!
Best regards.

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