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Should I repeat the HepB vaccine?
May 6, 2007

I am a dental hygienist and have had the HepB vaccine series two times in the last twenty years. I just had a dirty needle stick last week and my Dr. says I'm still showing up non-seroconverted. He asked me if I want to repeat the series and I have been researching but I cant find a definative answer. What tests should be done to see if I am truly part of the .04% of true non-responders? The first two series were deltoid injections and given in the proper time sequences. I administer local oral anesthetic at least 20 times a week and do consider myself to be at very high risk for another dirty needle stick exposure. Thanks for your help.

Response from Dr. McGovern

I am not sure if you mean that you knew that your were specifically exposed to hepatitis B virus. If so and your antibody is nonreactive, one approach can be the use of HBIG, a protective immunoglobulin. In the future, you can consider this intervention preferably within 72 hours of exposure.

However, for your ongoing risk and lack of seroconversion there are two possible routes for you that I would consider: 1. Using a double dose of the vaccine for 3 shots. 2. Using a total of more than three shots until seroconversion.

I would favor the double dose approach which has been successful in dialysis patients and HIV patients - both groups tend not have good seroconversion rates, but the double dose truly made a difference. This approach would definitely be a option for you.



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