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Hi Doctor I Am Just Wondering, I Took A Twinrix

Posted on Thu, 14 Nov 2019

Question: Hi Doctor

I am just wondering, I took a twinrix adult vaccination a month ago however no immunity has developed after one vaccine, I took the second dose yesterday, I understand you need three doses to complete the series, however would by the second dose at least show some form of protection (>10)??

I also did a hep b surface antigen test at 17 weeks came back negative due to exposure via deep kissing only

I'm just hoping the second dose would provide levels over 10 for immunity, is this normal to not develop antibodies by the first dose?

Regards
Jie

Answered by Dr. Dr. Antoneta Zotaj (1 hour later)

Brief Answer:
It is normal to not have increased antibodies with a single dose of Hep B vaccine- seroconversion improves greatly with the second and third dose

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

I carefully read your query and understand your concern.

Hepatitis B is considered a highly effective vaccine with a protection rate of higher than 90%. To reach this protection 3 doses of Hepatitis B vaccine are needed. This means that a single dose is not enough to provide protection in a considerable number of patients, as it has also happened with you.

In one study it was found that 2 weeks after the first dose of the hepatitis B vaccine only 1 in 5 patients had detectable antibodies in the blood (around 20%). These values jumped to 74% and 94%, soon after the second and third dose respectively.

So, I would say that it is very common for the antibody levels to be quite low after the first dose of Hepatitis B vaccine. Even with the second dose, the seroconversion rate can be just 80%, so one in five patients will not be seroconverted (will not produce antibodies). And only the third dose provides protection in more than 90% of the patients.

I hope this answers your query.
I remain at your disposal for further medical assistance.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Antoneta Zotaj (9 minutes later)

Hi Doctor Antoneta

thank you for your reply, yes the reason i took the vaccine was because exposure of deep kissing with girl, 17 weeks showed negative for surface antigen, I did advise the girl to take a test, she came back negative for hepatitis B and she advised me she has the paperwork to prove it, so i guess i can relax now

Regards XXXXXXX

Answered by Dr. Dr. Antoneta Zotaj (6 minutes later)

Brief Answer:
Negative HBsAg means you are not infected, but 3 doses of hepatitis B vaccine are indicated to give you protection for potential future exposure

Detailed Answer:
Hello and welcome back,

Thank you for your reply, it is my pleasure to assist you.

If HBsAg came back negative this is an indication that you are not infected by hepatitis B. In these cases, if you have not had hepatitis B vaccine series or if your anti-HBsAg is negative, 3 doses of Hepatitis B vaccines are recommended.
This is to provide you with immunity for future potential exposure.

So, yes, very likely you do not need to worry as you do not seem to be infected but due to low levels of antibodies, it is recommended that you take a total of 3 doses of Hepatitis B vaccine to keep yourself protected.

I hope this answers your query.
I remain at your disposal for further medical assistance.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

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Above answer was peer-reviewed by : Dr. Arnab Banerjee