Hep B vaccine x2, 0 titres

So someone I know has had the Hepatitis B vaccine twice, the most recent 2002. He had his titres checked and they are 0, just as they were prior to his receiving the second set of vaccines. Is there any point in getting revaccinated for the third time. For some reason, they just don’t seem to take.

Bumping this since I have a similar case, two doses of Hep B vaccine a couple years ago but never received the third.

I am most definitely not an expert in this - I bet Qadgop is, though.

As I understand it, about 5% of people fail to mount a response after their first series of vaccinations (i.e. 3 separate doses). Of those, about half will respond to a second series (of three more doses). Again, as I understand it, if a person has failed to respond after two series, they’re unlikely to respond, period.

There are two groups of people who tend to be unresponsive to the vaccine.

The first group is comprised of people who are immunosuppressed with end-stage kidney failure, typically on dialysis, and also by people who are immunsuppressed from other diseases (eg. with HIV, cancer, etc.). The second group of non-responders are generally healthy people, but have a particular genetic make-up which renders them unresponsive to the vaccine (this involves their HLA genes, i.e. the genes involved with immune response).

Note - people who don’t respond to two series of vaccine may actually have (occult) hepatitis B infection. So, although everyone should have had their hepatitis-B surface antigen tested before getting vaccinated, someone who doesn’t respond to the vaccine must most definitely be checked for it.

Then you are insufficiently vaccinated. Get the third shot in the series.

daurbach, on the other hand, appears to be describing someone who had two series of Hep B vaccinations and still didn’t develop Hep B surface antibodies (which indicate immunity to the virus). That means the person described got a total of 6 shots, but we still can’t prove he’s immune.

Otherwise, what KarlGauss already said.

Here’s what the (U.S.) Advisory Committee on Immunization Practices had to say about this situation in 2005:

• Persons found to have anti-HBs levels of <10 mIU/mL after the primary vaccine series should be revaccinated. Administration of three doses on an appropriate schedule (Table 7), followed by anti-HBs testing 1–2 months after the third dose, is usually more practical than serologic testing after one or more doses of vaccine.
• Persons who do not respond to revaccination should be tested for HBsAg.
—If the HBsAg test result is positive, the persons should receive appropriate management (see Appendix B), and any household, sexual, or needle-sharing contacts should be identified and vaccinated (see Appendix A).
—Persons who test negative for HBsAg should be considered susceptible to HBV infection and should be counseled about precautions to prevent HBV infection and the need to obtain HBIG postexposure prophylaxis for any known or likely parenteral exposure to HBsAg-positive blood (see Appendix C).

Centers for Disease Control and Prevention. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP); Part 1: Immunization of Infants, Children, and Adolescents. MMWR 2005;54(No. RR-16):29. http://www.cdc.gov/mmwr/PDF/rr/rr5416.pdf