Why did my vaccination for Hep A and B not work
Jan 25, 2009
I received three seperate series of twinrix and my body still shows no immunity to Hep A and B. Why is that and does it mean I am at risk to travel out side of Canada to tourist areas?
Response from Dr. McGovern
There are multiple points I would like to touch on regarding your question on Twinrix - a vaccine that combines hepatitis A and B vaccine in one.
Only about five percent of people don't mount an antibody response to these vaccines so routine checking of antibody titers after immunization is not usually done. I would ask your doctor as to why he/she did this in the first place.
If you got the vaccine for travel, you really only need hepatitis A, which protects against contaminated food and water. Hepatitis B is only acquired by blood to blood contact, eg, sexual transmission and injection drug use.
There are causes of lower overall efficacy rates for these vaccines. For example, hepatitis B efficacy can be lower in people who are overweight, smokers, have advanced liver disease, or in patients who are immunosuppressed.
At this point I would recommend that you can certainly go traveling. In high risk destinations, you will need to get important food and water safety advice from the cdc.gov website. I would also recommend that you get testing for hepatitis B surface antigen to be certain that you have never been exposed to this virus in the past.
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