If your body doesn’t respond as expected to the hepatitis B vaccine, your clinician may refer to you as a ”hepatitis B nonresponder.” This means you have little to no immunity to the hepatitis B virus. But with a doctor’s guidance, there are next steps you can take.

While many people who receive the hepatitis B vaccine obtain the intended protections, some might not.

Healthcare professionals can often consider you a “nonresponder” to the hepatitis B vaccine if, after receiving two courses — the exact number of injections differs across brands — you have lower than expected levels of hepatitis B surface antibodies (anti-HBs) in your blood.

Anti-HBs protect against the virus. The higher your anti-HB levels, the more protection you have against the hepatitis B virus.

People who respond to the hepatitis b vaccine usually have 10 to 12 milli-international units per milliliter (mIU/mL) of anti-HBs. People who do not respond to the hepatitis B vaccine have less than 10 mIU/mL anti-HBs.

According to one 2021 study, approximately 5% to 10% of recipients do not respond as expected to an initial course of the hepatitis B vaccine.

Research from 2015 found that 50% to 60% of people who do not respond initially develop the appropriate antibodies after receiving an additional dose.

Experts consider people who do not respond initially, after an additional dose, or after a second course of the hepatitis B vaccine to be “true” nonresponders.

The 2021 study above suggested that newer — so-called second- and third-generation — vaccines are more effective at overcoming nonresponsiveness.

Although experts need more research to fully understand why some people do not respond to the hepatitis B vaccine, genetics, age, sex assigned at birth, and overall health may be factors.

You may be more likely to be a nonresponder if you have:

It’s important to note that having a weakened immune system or chronic health condition does not automatically guarantee that your body will not respond appropriately to the hepatitis B vaccine.

If you still need to start a vaccination course, it’s worth talking with a healthcare professional about your options.

The Centers for Disease Control and Prevention has developed additional guidelines for people with certain chronic health conditions to increase the likelihood of effective vaccination.

They only recommend that the following groups refrain from getting the hepatitis B vaccine:

  • people who had a severe allergic reaction to an earlier dose
  • people who know they are allergic to a component of the vaccine
  • people who are allergic to yeast

If you’re a nonresponder to the hepatitis B vaccine, reducing your risk of exposure and infection is important.

Some expert-recommended ways to minimize exposure to hepatitis B include:

  • talking with your partners about their STI status before engaging in sexual activity
  • using condoms, gloves, and other barrier methods during sexual activity
  • opting for reputable tattoo and body piercing studios that practice proper sterilization practices
  • avoiding sharing needles, syringes, and other sharps whenever possible
  • disinfecting wounds and surfaces touched by blood and other bodily fluids

If you experience hepatitis B exposure, you can still receive immunoglobulin injections for short-term prevention and protection.

If you’re among the 5% to 10% of people who are initially nonresponders to the hepatitis B vaccine, there are steps you can take.

Some people experience effectiveness from the second round of vaccinations, so talk with a healthcare professional to see if this is right for you. They can also advise you on how to reduce your risk of contracting the virus.

John Loeppky is a disabled freelance journalist who currently resides in Saskatoon, Saskatchewan, Canada on Treaty 6 territory. His work has appeared for CBC, FiveThirtyEight, Defector, Insider, and a host of other publications. He can be reached at John@Jloeppky.com and his goal in life is to have an entertaining obituary to read.