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my doc refused to give me Hep B vax why?
Feb 4, 2004

Dr. Bob,

Please give me your honest opinion. My doc who is extremely nice kinda looked at me funny when i informed them that i wanted to get vax against Hep B. They just said well you don't sleep around, insurance doesn't cover it, and i feel that it is totally unnessary in your case Mr. Postman (thats who i am). But i do not like this answer. I was wondering why a doctor might refuse to give this vax? Is it a relatively new and unknown vax that might be dangerous? What are the possible negative implications? Perhaps they are worried I might be hiv positive? Does this have anything to do with it? I did test out to 3 months on standard testing but i was wondering what you think? What should i do, I love sex and i wonder if this vax is a good investment in your eyes? How does it work, what is the procedure.

Thanks!

P.S. I don't want no dog biting my ass!

Mr. Postman

Response from Dr. Frascino

Hello Mr. Postman,

First things first. Dogs biting your ass isn't exactly the same thing as having sex . . . well, for most people anyway.

Next, how does your extremely nice doctor know if you sleep around or not? That's a bit presumptuous on his part, especially since you "love sex" and have been getting HIV tests, which would indicate you deliver more than the mail form time to time.

Hepatitis B vaccination is quite effective and also a bit pricey. It requires three injections. You should be screened first with a blood test to see if you have been previously exposed to the virus and perhaps are already immune. In the United States, the prevalence of hepatitis antibodies (indicating past exposure or vaccination) is 35-80% for men having sex with men, 60-80% for injection drug users, 60-80% for hemophiliacs, 5-20% for heterosexuals with multiple partners, and 3-14% for the general population. I don't know what type of sex you "love," or if a mailman "comes" more than once a day, but you can check the prevalence rates listed above to get an idea of how common hepatitis can be. Your physician can let you know the price of the three-injection series and screening blood tests. Then you'll have to decide if it's worth it or not. I should also mention that the vaccination won't do a thing to keep those pit bulls from chomping on your butt.

Dr. Bob



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