Did your Hep B Vaccine Take?

[jmjm530]

My series of Hep B vaccines did not take.

This the third time I've had the series, and while the first two times I might have missed the third shot -- this time I got all three shots within the required time period.

Wondering what the collective experience here is on the Hep B vaccine. Did it take after the first series? After the second series? Did you have a third series? Did you double dose at some point?

I'm guessing the next step is the doc will double-dose the vaccine -- either that or tell me to forget about it.

-- Jim

[mremeet]

I just had my HBV vaccination completed last summer (condensed 3 shots within a month). I don't know if mine took or not, guess I should have that checked. The nurse who gave the shots did inform me though that in recent years it has been learned that the amount of anti-HBV antibodies required for protection are considerably lower than what used to be considered "safe" (i.e. protective). She said that it was found that those even with UND HBV antibodies (ab's resulting from vaccination) which occurred as their vaccinations were "old" were still protected from HBV infection. For this reason she told me that the usual HBV vaccination protection duration has been extended much longer than had originally been thought possible when the HBV vaccine was first developed and used (I believe about 10-20 years ago?). She told me that I would be protected for 10 years and that I should investigate what is known about HBV vaccinations after that time to see if the knowledge base on the subject dictates coverage even longer than that. She said it might even be possible I would be protected for life, but she could not attest that with any certainty.

I never looked into what she told me to verify its veracity, but she did seem like a sharp nurse. Anyway, something to consider if you have what might be considered marginal antibody levels to a possibly outdated standard. If HR reads this maybe he can clue us in about it too.

[jmjm530]

Thanks for the input. Maybe HR will have some insight, as you suggest.

My Quest labs read as follows:

HAV AB, TOTAL        Reactive
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HEPATITIS B SURFACE AB,QN
9    (appears to be under "reactive" column)      L  (Reference range > ./=10 mIU/mL)
Patient does not have immunity to hepatitis B virus.

----------------------------------------------------------------------

HEPATITIS B SURFACE AB, QL
Indeterminate * Non Reactive
----------------------------------------------------------------------



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[denzelbrown]

mine are 8, and the i was told me to get another booster shot!! is there s risk of vaccine if u have hep c?
thanks

[copyman]

denz, the reason they want people with Hep C to get the A & B shotss because it could be deadly if you get A or B added to HCV!  two viruses eating the liver at the same time.

Jim, i got my last shot of the series of 3 around 4 months ago. i will be getting the anti body test bloodwork to see if they took, i will let you know

[beamishboy]

i only had one shot forA&B pre-trx...i asked for anti-body test post-trx and it showed anti-bodies for both...i don't believe i need a booster...right?

[Harry Potter]

Mine took from the first series of shots; however, this was a few years before I became infected with Hep C.  My best friend's Hep B series didn't take after the first series of shots, but upon receiving one extra dose, it took.  I guess everyone's just different that way.  Are some people naturally immune to Hep B without immunization, or am I just making that up?

[gizmoesgirl]

Hi my first vaccine for Hep B 10 years ago did not take however I did not kow that until recently.  They gave me a booster last week and they are gonna test me in 30 days to see if this one took.  Im not sure about getting the whole series again though.  My PCP and My GI doctor advised that it is not OK to give the series more than once.  So if this booster did not take im not sure what they will do!  

[Myown]

Mine didn't take. I think they said I'll get the double this time. I'll check it after the first of the series though since some seem to have only needed that ONE extra shot.

[ruth709]

halo,guys....can anybody help me interpret the result of my med test a while ago...thnak you very much.

SGPT: 58.10   normal value should be 0-49 mg/dl
Hbs Ag Sreening Test: Reactive

Thanks again!

[alagirl]

I'm a little confused.  What do you mean they didn't take?  How do you know?  I had the A and B Vaccine series as did my son.  I had my series about four years ago after I received a blood transfusion.  My son, of course, had his as a youngster.  My rapist's prison records show he was positive for all three heps, A, B and C (although probably not transmitting the A given that the records were a few months old [pulled from his last incarceration] - at least as I understand the the A virus to work?  You clear it but it leaves the antibodies?  But in any case, he definitely had not been treated at all for the B or C) I only got Hep C and God knows my immune system just loves to glom on to any available virus just for the sheer sport of it, so I'm thinking my Hep B vaccine was "working."  Hard to say though, I could have just been "lucky."  Or maybe the Big Guy Upstairs was trying to save me from a complete and total nervous breakdown... ;)

[alagirl]

Many physicians recommend HCV positive patients go ahead and get immunized for Hep A & B so I would think that there is felt that there is not much risk.  They also typically recommend a flu shot for HCV positive patients.

[jmjm530]

Antibody blood tests for both "A" and "B" will tell you if it "takes", i.e. if you have enough of an antibody level to fight off either.

In my case, the Hep A vaccine worked and the Hep B didn't. This is not uncommon for the Hep B vaccine not to take.

I assume, or at least hope. that your docs followed up and checked your antibodies at some point after your vaccines, easy enough to ask.

The tests you need are the ones I posted earlier in the thread where I show the values.  At least those are the way the tests are reported from Quest Labs.

As mentioned, sometimes if they don't take, they then double-dose the vaccine.

-- Jim

[desrt]

Does the !@#$% actually have chronic HBV or just the antibodies? My understanding is that chronic HBV is fairly rare.
My experience with 'naturally' acquired HAV/HBV antibodies (exposures 1961/1973 respectively) are that the antibodies are durable.

[alagirl]

You know, I really don't know, on the chronic.  I don't know much about HepB, I'd thought that it was like HCV, and normally chronic unless untreated...  So perhaps that was the case there and his was just was not communicable.  I'll get my hep doctor to test me next time I see him so I can ask him for the appropriate tests (instead of trying to get my primary care doc to try to hash it out - that didn't work out so well when we did the viral load genotype testing.  I don't know if you guys remember, but they ordered it incorrectly, took the lab three miserable weeks to get the damn thing back).  

But definitely, with my health history I want to make certain I'm covered.  With so many people here having gotten the vaccinations after they had HCV and the vaccinations not seeming to take as well, I wonder if the HCV - and hey, this is way out in left field - somehow affects the vaccine?  Nah.  Probably not possible.  Anyway, I'll go ahead my doc test mine.  I NEVER want to have to go through a hideous treatment like this again LOL

Speaking of which, I know its on a different thread but can you BELIEVE they are letting that #^@#@ doctor who shared needles between patients keep his license?  I'm going to write to the medical board in that state and "share" with them just a little bit about what its like living with and treating this disease.  That man does not deserve to continue to practice.  Its an abomination.

[alagirl]

Oh yeah, and gee thanks Jim, posting this thread and giving me something completely new to worry about... whether or not my vaccines are working - not to mention my 19 yr old's (sticking out my tongue at you) LOL ;)

Just kidding.  We need to have all the info, great or not.

[drofi]

Jim,

I have done some literature research on this topic some months ago, but unfortuantely several articles are written in German again. Here is what I have learned from the studies:

1.) Jilg et al., Impfversagen nach Hepatitis-B-Impfung, Einfluss zusätzlicher Impfungen, Dt. med. Wschr. 115 (1990) 1545-1548.
Re-immunisation (1 to 3 times)  of nonresponders resulted in response (6 of 14)

2.) Dennhöfer, Hepatitis-B-Schutzimpfung – Zum Problem der ungenügenden Anti-HBs-Bildung, Dt. med. Wschr. 115 (1990), 1560-1565.
He describes some factors affecting response rates. A higher dose (40 ug instead of 10 ug) is sometime helpful,
A longer interval between immunisations (> 6 months) improves response quality. Interestingly the time of the day (!) had an influence on response rates: Immunisations late afternoon gave better results than early in the morning. The authors suggest a connection to th corticoid level, which is depending on the daytime.

3.) Hofmann et al., Zur Effizienz der Hepatitis B-Schutzimpfung, Gesundheitswesen 59 (1997) 537-534.

A large group of workers at a german university was tested (5035 persons). The best results had women compared to men, jounger beter than older, low BMI beter than high BMI, non-smokers.

4.) Rosman et al., Improving the Response to Hepatitis B Vaccine. Infections in Med., 1999, 205
The authors find better results with higher doses (40 ug) than 10 ug.

5.) Alper et al., Genetic Prediction of Nonrespons to Hepatitis B Vaccine, New Engl. Journ. of Med., 1989.
The authors describe a genetic componenet as responsible factor. This genes do not affect other immunisations.

6.) Stück, Lowresponder nach Hepatitis-B-Impfung im Kindesalter.  Pädiat. Prax. 58, 577-578 (2000).
This work describes bad response in persons with occult HCV infection.

Conclusion from these publications:
The best place for an immunisation seems to be the upper arm. The best time of the day the afternoon. Higher doses and repeated immunisations (long intervals) work sometime. Reimmunisations after the first round should be done after a longer interval, which is 6 months and 18 months.

Good luck! drofi

[drofi]

Qoute: "women compared to men"

should be females compared to males :-)

[jmjm530]

Thanks. Now, if I get this right, combining all the studies --

I should do a higher dose, with longer intervals, in the late afternoon, injected into the upper arm, after visiting Jenny*, and after having a sex change operation. Except that I should have done all this at age 16, before I started smoking and probably in Germany, where they understand all these things.

You know -- I was going to ask my doc to  try another series, but now not quite sure it's worth it :)

*http://www.jennycraig.com/

[jmjm530]

Oh yeah, and gee thanks Jim, posting this thread and giving me something completely new to worry about...
--------------------------------------------
Listen, any time your stress hormone levels just aren't delivering, just let me know.

[drofi]

Hi Jim,
no, you did not get it right.
To change your sex has a bad risk/benefit ratio and probably would not increase response rate, because it does not change the sexual genotyp, the phenotyp only. Not a good idea, but nice thought. To stop smoking would be helpful anyway and you can do it wherever you are.
Your other conclusions are correct.

[alagirl]

This work describes bad response in persons with occult HCV infection.
-------------------------------------------
Drofi - suspected that was going to be the case.  I'll check out my vaccine but I'm willing to bet its ok.  I did mostly everything right.  Low bmi, afternoon, female, ok yeah, I was 36 - so sue me - don't smoke, didn't have HCV at the time, good intervals on immunizations, decent doses.  Still, I'll test it and make certain.

Jim - on that stress thing.  Somehow knew I could count on you....

[drofi]

Hi Ala,
sure, these conclusions from the papers are statistical data only. It is the same with SVR rates: For the statistics it is not important on which side of the 50% you are individually, but for yourself it is...
However, this forum has some mood improving effect anyway. I am curious which alias Jim will use after joining jenny craig and having finished his/her sex change operation.

[alagirl]

For me, stats mean a good bit though... I'm all about the statistics.  Which is fairly ironic actually since my body seems to do the most stupid things, defying all rational thought a great deal of the time.  Unfortunately, it seems like when hoofbeats are heard in my case too often zebras really are coming around the damn corner.

As to the other, my money's on Jenna 2, or Jenna Too... I'm seeing something in kind of a twins dynamic going on.  

[beamishboy]

ahh the beat goes on...why zebras tho? never fails to amaze me when the buffalo thunder acrossed my back forty...or those smug canadian geese with their upstart loonies& damnable socialised medicine making whopee all nite long..i mean really,what are the odds?.....hope your inna grin in bear it day- {-:

[jmjm530]

Of course, Jenna will have a simultaneous sex change operation (double change discount). We will then swap names. It's all planned out to germanic precision. Or is that Swiss precision? Anyway. And yes, Drofi is correct, these are just stats. Ala, in all probability you already have had those tests done, but it sounds like it may be easier to repeat them than to fetch the old records.

-- Jim (for now)