[Question #10907] Hepatitis B (follow up question)

18 months ago

Dear Dr Handsfield,

I posted the other day (you replie but wanted to ask you an additional question.

To recap - I am 48. I had the accelerated Hep B vaccine in 2005 in UK (0, 1 and 3 weeks, though may have been at 4 weeks.) My titres were very low (I think 2) so I had a booster in 2010 (rose to >1000). I believe the level was around 800 in 2019.

I gay male with Hep B performed oral sex on me this week.

I am currently taking Prednisolone for a UC flare up.

I will be starting a new medication (Ozanimod) for UC which suppresses the immune system.

My question: is there an indication for me to have a booster Hep B vaccination, since I haven't had one since 2010?

Thank you in advance.

H. Hunter Handsfield, MD

18 months ago

Probably there is no need for a booster; most experts believe protection to be life long even if the antibody level declines to undetected levels. With detectable antibody about 5 years ago, probably you are still protected. But you're free to consult an infectious diseases physician or other expert on this, which could include another HBs antibody test to be certain. I really do not think it necessary. On the other hand, it never hurts to have extra HBV vaccine doses, so that's also an option if you prefer.

HHH, MD

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18 months ago

Hi Dr Handsfield,

Thanks for your reply.

My antibody level was 800 in December 2021 (not 2019 as I said) and I just had it re-checked and, two years on, it is now 600.

From what you said, it sounds like I don't need a booster.

If I do opt to have a booster, is it best to wait until after the course of prednisolone is completed (as I imagine the response to the vaccine will be stunted while I take prednisolone)?

Thank you.

H. Hunter Handsfield, MD

18 months ago

You don't need it -- don't waste your (or some clinic's) money.

Vaccine responses are not usually suppressed by steroid treatment but you shouldn't be vaccinated anyways so it's not an issue.

You're clearly obsessed with this. But you will never get HBV in your life, no matter what exposures you may have. Do your best to move on without giving this another thought.

That concludes this thread. Please note the forum policy against repeated questions on the same topic. This must be your last about your hepatitis B concerns; more would be at risk of deletion without reply and without refund of the posting fee. Thank you for your understanding. I do hope the two discussions help you move on and leave this topic in your dust.

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