Hepatitis B Vaccine... Needing Answers

Nurses General Nursing

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I am a nursing student and I posted this in the student forum but thought I would post it here to see if others had some input on this as well :)

I am sure for the most of you have had your 3 step Hep. B vaccine and then after the third one about a month later you go and get your blood drawn and the see if your body as made the antibodies?!? Well, I got home from school today and I had a message on the machine from my doctor. She said that my test was negative which means that my body thinks I have never had Hep. B, so my body did not make the antibodies it was suppose to of made.

What do I do now? Anyone else have this problem or know what I should do? When then checked for Rubella my body had made the antibodies.

She said I should check with my school about what I should do, since they have requirements. I will but I really wanted this for my own protection from patients who have Hep. B.... I am sure you understand! You never know what your patients in clinicals might have sometimes.

If any of you can answer this I would greatly appreciate any light you could shine on this. I will call the Dr. back tomorrow but I am curious about things now.

Thanks!!

Amy L

Specializes in Peds Homecare.

Hi, I have a similar problem. I was feeling tired and run down, so I went to the dr. I had a cbc drawn and when the results came back my dr. redid the cbc...and again...and again. By this time my nurses imagination was running overtime. Now I always forget the name of the stuff, but it's the stuff in the tube that is at the bottom, that they mix with your blood. My blood reacts with that and it shows I don't have enough plattlets. Seems it makes them clump together and when the machine does my blood count, it says I don't have enough. Well my dr. didn't know that alot of people have this problem. So I had to go to an oncologist, scarry, very scarred. Seems this is something they knew about and the first thing they do when someone comes with that diagnosis, they draw blood without anything in the tube. So I was fine, I have plenty of plattlets, now to my similar problem. Well I had a rubella titer drawn when I went to nursing school(back 22yrs ago). This was the titer all my employers had used, i was told it showed immunity. Was written the old way. Well eventually, someone really checked into it. It showed I had no immunity for rubella, even though after checking with my mom who said I had it as a a child. So I had to get an mmr. Work was satisfied and I went on from there. Well I was going to work at the level one trauma center in syracuse, I had to have a titer drawn again, guess what? No immunity. My doctor insisted that I get another mmr, because of going to work at Upstate. A while ago I heard that they were going to draw blood for a titer for hep b of the people who had the vaccine 10yrs ago, when the shots first came out. I do home care and the subject hasn't come up yet, but I am very worried about it. So no solution, just know how you feel. Never heard of anyone else with this problem either. Let me know if you find anything out.;)

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

Try the CDC site.

http://www.cdc.gov/ncidod/diseases/hepatitis/b/postvac.htm

I was one of the first nurses in SC to get the Hep B vaccine after a stick.......the hospital actually tried to BILL me for it. It went all the way to the State Dept. of Health but I had work. comp pay for it. That's been 12 years ago I think. It wasn't mandatory til '91.

I STILL have antibodies. My bro-in-law is a cop and has NEVER developed them. His doc said he was still protected and wouldn't give him another series.

Anyway when it comes to disease questions...I always look to the CDC!

I had the Hep B series back in 1991, and I was tested recently at the hospital I am currently working at. Guess what?...no antibodies at all. They suggested that i retake the shots and see if I develop antibodies. Some people never develop antibodies to it. They are also finding out that some may need booster shots after 10 years or so. Also if you protect yourself through Universal precatuions, you are doing the best protection for yoursel.

What we do is repeat the series for Hep B and if it comes back neg again we do not do it for a 3rd time. It is a must to have it required by ALL health care workers.

I do know some that did not build antibodies but all you can do is have it and hope it works.

Hi, I am one of those who won't get antibodies.

Tried different sera, my doctor here even let some come from the UK, but that still didn't do the trick!

I've had about 12 shots, but nothing works!

Well I just have to be very, very careful.

The interesting thing is though, that I have mad enough antibodies after my Hep. A-Shots!

Nobody knows why.

Take extra care, Renee

Amy, I work in the immunization dept at a county health agency where we give alot of hep B series. I just started hep B series for the county jail and have to draw their titers when we are finished with them. In checking with the local hospital, I spoke with one of the dr's in the lab to find out when is the best time to draw the titers....CDC suggest anywhere from 1-6 mos for titers to be drawn. The dr at the hospital lab said draw the titers as close to the end of the 6 mos after finishing the series as possible to allow for optimal time for you to build antibodies. Since the titer was drawn only a month after you finished the series, maybe you could go back at the end of the 6 mos after finishing the series and have another titer drawn. At least this way you can avoid more shots and maybe you will have immunity by then. Hope this helps....Terri

Specializes in ER, PACU, OR.

i had to go back for a booster.......and still nothing? then a second booster!!!!!! i have been fine since!!!!!! some people don't respond as easily as others.......no biggie. go back get a booster and have your titer re checked.

me :)

I have no antibodies either, after the full series and a booster. I was told not to get any more shots, that I'm covered. Now, I don't know what that means, really, and am REALLY careful about my universal precautions. What does the CDC say about that?

I like you am a non-responder to the vaccine. I have had two complete series of the vaccine and one booster. These were met with no response. So I am considered to be at risk for Hepatitis B infection, I take this in stride though, as I am also at risk for Hepatitis C, and AIDS, like everyone else. So you have to be extra careful in situations where you may get an exposure to a potentially infectious substance. I know this doesn't help much, but at least you know you are not alone.

See these links for a discription of the offical thought on non-responders.

BTW did you know that three days ago a report came out saying that Hep C is curable in the early part of the infection. Apparently using interferon A and an antiviral drug early will halt viral production and allow the body to clear itself of the virus.

Hepatitus FAQ from Dept of labor

Hepatitis and the Healthcare worker.

I used to be an Infection Control nurse- that is true that some people never seroconvert to an immune status. No one knows why.

You should have a titer q 10 years and booster if needed.

The series can be repeated once, if no immunity established then you are one of those persons who aren't going to seroconvert.

Thank you to all who responded. You all made me feel better knowing that I am not the only one out there with this problem.

I have made an appointment to see my MD again, I can't get ahold of her without and appointment it seems. I am going to ask her what she thinks I need to do. I am thinking about getting the booster and see if that works, and then I'll go from there I suppose. She said earlier to find out what my school requires me to do. That is all great, but I am more concerned about getting the protection I need but if my body won't make the antibodies after the booster and or the series again I'll just have to deal with it!

Thanks again to everyone who took the time to respond, I appreciate it and I'll keep you posted.

Amy L.

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