Concerns Regarding Hepatitis B Immunity
A 25-year-old female paramedic is facing some puzzling health concerns. She has a history of medical conditions including endometriosis, a hiatus hernia, eczema, and asthma. Her current medication regimen includes pregabalin, ryeqo, and pantoprazole. Additionally, she takes cocodomol and lactulose as needed for discomfort, alongside propranolol for anxiety when necessary. She stands at 5 feet 5 inches tall and weighs around 11 stone. After quitting smoking, she has shifted to vaping as an alternative. In 2021, she completed the full course of hepatitis B vaccinations through her workplace's health department and was later confirmed to have immunity based on her titre levels. However, after recently undergoing blood tests for another job, she received unexpected results indicating that her hepatitis B titre levels show no evidence of immunity. This revelation has left her bewildered, especially since she had confirmed immunity just four years prior, along with the belief that the vaccination series should provide protection for at least 20 years. She is now concerned about whether this abrupt change signifies an underlying health issue for her.
Answers (1)

9/9/2025, 1:40:45 PM
OpenHealth AI
It's understandable to feel concerned after receiving unexpected results about your hepatitis B immunity, especially given your previous confirmation of immunity. Changes in hepatitis B antibody levels can occur for several reasons, and it’s essential to explore them thoughtfully.
Explanation
Hepatitis B vaccines are generally effective, and immunity can last many years, often over 20. However, there are instances where the body's response to the vaccine may wane over time or might not produce consistent antibody levels. Factors that can affect immunity include:
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Immune System Variability: Certain health conditions or the use of certain medications can alter how your immune system responds. For example, medications like pregabalin and propranolol may have some effect, but your use of multiple medications and underlying health conditions should also be considered.
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Testing Variability: Lab tests can sometimes yield fluctuating results due to different methodologies or the timing of tests.
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Potential Underlying Conditions: Conditions that affect the immune system could potentially diminish the effectiveness of vaccinations.
Next Steps
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Seek a Repeat Test: Consider scheduling a repeat antibody test. This can help confirm if the initial results were accurate or if it's a discrepancy.
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Discuss with a Healthcare Provider: It’s important to talk to your healthcare provider about these results and your concerns. They can review your medical history, current health status, and medications to provide tailored insights.
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Consider a Booster Dose: If confirmed low titre levels persist, your healthcare provider might recommend a booster dose of the hepatitis B vaccine. This can help restore immunity.
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Monitor Symptoms: Keep an eye on any new or unusual symptoms. If you notice any issues that concern you, notify your healthcare provider.
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Stay Informed: Continue educating yourself about hepatitis B and your health conditions. This knowledge can be empowering as you navigate your concerns.
Remember, you are not alone in this, and there are steps you can take to address your health and privacy concerns. Always trust your instincts and seek support when needed.
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