Hepatitis B vaccine in children: antibody still negative after three doses

Apr 10, 2023 Source: Cainiu Health

Dr. Yang Ziqi

Introduction

A child's hepatitis B antibody test may still be negative after completing three doses of the hepatitis B vaccine due to insufficient dosage, drug interference, immature immune system, improper vaccine storage, or infection with the hepatitis B virus. If the administered dose is inadequate during vaccination, it may fail to induce sufficient immune response, resulting in a negative antibody result.

Generally, if a child's hepatitis B antibody test remains negative after completing the full three-dose hepatitis B vaccination series, possible reasons may include insufficient dosage, medication interference, immature immune system, vaccine storage issues, or existing hepatitis B virus infection. Details are as follows:

1. Insufficient Dosage

If the dose administered during hepatitis B vaccination is inadequate, it may fail to trigger sufficient immune response, resulting in a negative antibody result.

2. Medication Interference

Certain medications, such as immunosuppressants or chemotherapy drugs, may impair immune system function and thereby reduce the effectiveness of the hepatitis B vaccine.

3. Immature Immune System

Some children may have underdeveloped immune systems that are unable to produce adequate levels of antibodies following vaccination.

4. Vaccine Storage Issues

If the vaccine has been improperly stored or transported, the antigen components may lose their activity, compromising the vaccine's immunogenicity.

5. Hepatitis B Virus Infection

If a child has already been infected with the hepatitis B virus before receiving the vaccine, the vaccine will not prevent the infection. In such cases, the antibody test may remain negative even after completing all three doses. The child should seek medical attention promptly and, under a doctor’s guidance, may require antiviral treatments such as entecavir granules, lamivudine granules, or adefovir dipivoxil granules.

If a child has completed the full three-dose hepatitis B vaccination series but still shows no antibody production, parents should consult with a healthcare provider to evaluate the vaccination history and determine appropriate follow-up measures. Re-vaccination or other protective strategies may be necessary to ensure the child's health.

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Can short-acting interferon be used again after having been administered for 4 years and then discontinued for 4 years?

If the underlying disease (e.g., chronic hepatitis B or C) is currently in an active phase, with abnormal liver function or elevated viral load, and no severe baseline conditions (e.g., cirrhosis) have occurred during the 4-year period off treatment, the patient may be eligible for re-treatment—provided a physician evaluates them as having good overall tolerance and no contraindications to interferon use (such as severe cardiac or renal disease, or psychiatric history). An individualized dosing regimen would then be required.